Abstract
BackgroundAiming to eliminate HIV infection, UNAIDS has set a global “90-90-90” target by 2020. We sought to construct a 6-stages HIV Cascade of Care (CoC) in Greece, overall and by risk group, to assess risk-group and stage-specific progress in achieving the UNAIDS target.Patients and methodsCombining data from the HIV/AIDS surveillance system and a population-based HIV cohort study, the CoC included: i) number of people living with HIV (PLHIV) by end of 2013; ii) proportion of PLHIV ever diagnosed; iii) proportion of diagnosed linked-to-care iv) proportion of linked-to-care ever initiating antiretroviral therapy (ART); v) proportion of treated who retained-in-care vi) proportion of those retained-in-care who were virally suppressed (≤200 copies/mL) at their last visit (01/07/2012-31/12/2013).ResultsIn 2013, 14147 PLHIV were in Greece. Overall, proportions of each stage in the cascade were: 78.4% diagnosed; 86% linked-to-care; 78.5% initiated ART; 86.4% retained-in-care, and 87.1% virally suppressed. Totally, 42.6% of all PLHIV were virally suppressed. The percentage diagnosed was lower among heterosexual men and women (heterosexuals) than in MSM (men who have sex with men) or PWID (people who inject drugs). Most MSM were linked to care (97.2% of diagnosed) while a substantial proportion of PWID were not (80.8% of diagnosed). Once treated, PWID remained in care in similar proportions to MSM. Unlike PWID, a high proportion of the retained in care MSM and heterosexuals achieved viral suppression.ConclusionsAt the end of 2013, we identified gaps in the HIV CoC in Greece, which differed across risk groups. Targeted interventions are critical in optimizing early diagnosis and timely linkage. A 6-stage CoC, stratified by risk group, can inform strategic public health planning in improving HIV treatment outcomes.
Highlights
Combined antiretroviral therapy (ART) improves both individual patient survival and prevention of onward HIV transmission [1, 2]
Combining data from the HIV/AIDS surveillance system and a population-based HIV cohort study, the Cascade of Care (CoC) included: i) number of people living with HIV (PLHIV) by end of 2013; ii) proportion of PLHIV ever diagnosed; iii) proportion of diagnosed linked-to-care iv) proportion of linked-to-care ever initiating antiretroviral therapy (ART); v) proportion of treated who retained-in-care vi) proportion of those retained-in-care who were virally suppressed ( 200 copies/mL) at their last visit (01/07/2012-31/12/2013)
At the end of 2013, we identified gaps in the HIV CoC in Greece, which differed across risk groups
Summary
Combined antiretroviral therapy (ART) improves both individual patient survival and prevention of onward HIV transmission [1, 2]. Despite advances in treatment and innovations in prevention, such as pre-exposure prophylaxis (PrEP), HIV remains a major global health issue. Given the high effectiveness of ART, HIV transmission and associated mortality are largely attributed to the substantial number of HIV-infected individuals who remain undiagnosed and/or untreated. Unless a sufficient number of the people living with HIV (PLHIV) are engaged in all the above-mentioned steps, the public health of ART provision cannot be realized. Aiming to eliminate HIV infection, UNAIDS has set a global “90-90-90” target by 2020. We sought to construct a 6-stages HIV Cascade of Care (CoC) in Greece, overall and by risk group, to assess risk-group and stage-specific progress in achieving the UNAIDS target
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have