United Nations Programme On HIV/AIDS Research Articles

Knowledge and attitude of secondary school students in Nakaseke, Uganda towards HIV transmission and treatment.

Background: One of the major health concerns in Nakaseke district, Uganda is the high prevalence of HIV/AIDS. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), as of March 2014, the prevalence rate of the disease in the district was estimated at about 8%, compared to the national average of 6.5%, making Nakaseke district have the sixth-highest prevalence rate of HIV/AIDS in the entire country. We set out to explore the knowledge and attitude of secondary school students in Nakaseke, Uganda on HIV transmission and treatment. Methods: This was a cross sectional survey-based study with data collected during the month of February 2020. Data were analyzed using R programming language version 3.6.2. Results: A total of 163 participants volunteered for the study, 53.37% males and 46.63% females with ages ranging from 12 - 20 years. Participants came from 5 senior classes (S1, S2, S3, S4 and S6). In total, 87.73% participants were aware of HIV/AIDS while 12.27% were not. The major source of information was through teachers/schools. 96.50% knew the mode of transmission of HIV/AIDS and 95.11% were conversant with HIV/AIDS prevention. 63.6% were aware of the terms DNA and genes whereas 36.36% were not. Discussion:Generally, the students in Nakaseke district, Uganda had a high level of awareness of HIV/AIDS based on Bloom's cut-off point. However, with regards to aspects such as the cause and modern prevention methods like taking prep and prevention of mother to child transmission were less known to them. Efforts to find a cure for HIV/AIDS are still in vain. Therefore, strong emphasis on up to date control and prevention methods should be implemented to fight the HIV/AIDS scourge .

Knowledge and attitude of secondary school students in Nakaseke, Uganda towards HIV transmission and treatment

Background: One of the major health concerns in Nakaseke district, Uganda is the high prevalence of HIV/AIDS. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), as of March 2014, the prevalence rate of the disease in the district was estimated at about 8%, compared to the national average of 6.5%, making Nakaseke district have the sixth-highest prevalence rate of HIV/AIDS in the entire country. We set out to explore the knowledge and attitude of secondary school students in Nakaseke, Uganda on HIV transmission and treatment.Methods: This was a cross sectional survey-based study with data collected during the month of February 2020. Data were analyzed using R programming language version 3.6.2.Results: A total of 163 participants volunteered for the study, 53.37% males and 46.63% females with ages ranging from 12 – 20 years. Participants came from 5 senior classes (S1, S2, S3, S4 and S6). In total, 87.73% participants were aware of HIV/AIDS while 12.27% were not. The major source of information was through teachers/schools. 96.50% knew the mode of transmission of HIV/AIDS and 95.11% were conversant with HIV/AIDS prevention. 63.6% were aware of the terms DNA and genes whereas 36.36% were not.Discussion: Generally, the students in Nakaseke district, Uganda had a high level of awareness of HIV/AIDS based on Bloom’s cut-off point. However, with regards to aspects such as the cause and modern prevention methods like taking prep and prevention of mother to child transmission were less known to them. Efforts to find a cure for HIV/AIDS are still in vain. Therefore, strong emphasis on up to date control and prevention methods should be implemented to fight the HIV/AIDS scourge .

Сomparative epidemiological and demographic characteristics of TB and HIV infections among military personnel of the Russian Federation and USA armed forces and armed forces of National liberation army of people’s Republic of Сhina

More than 1,7 million people, 770 thousand people from HIV infection, died from tuberculosis worldwide in 2018. In accordance with the United Nations Sustainable Development Goals and the World Health Organization’s strategy to fight tuberculosis, all countries need to reduce the incidence of tuberculosis by 80% and reduce the death rate from tuberculosis by 90% by 2030. According to the Joint United Nations programme on HIV/AIDS (UNAIDS) goals of «90–90–90», countries should achieve the following indicators by 2020: «90% of people living with HIV infection should know their HIV status; 90% of those who know about their HIV infection should receive treatment, and 90% of those who are being treated should not have their viral load determined». Socially significant diseases are a serious problem for the Russian Federation (RF). The RF is one of 30 countries with a high incidence of tuberculosis and ranks 3rd place in multidrug-resistant tuberculosis and 6th place in the prevalence of HIV infection. Socially significant diseases present a serious problem for the Armed Forces of the RF. 150 new cases of tuberculosis, over 50 cases of HIV infection are diagnosed every year among military personnel of the RF Armed Forces.The purpose of the studyis to analyze the current epidemiological situation of tuberculosis and HIV infection in the armed forces of the Russian Federation and foreign armies, to generalize domestic and foreign experience in the organization of medical care for military personnel with these diseases.Data from reports of the medical service and a review of domestic Russian and foreign medical literature allowed us to assess TB and HIV sickness rate among military personnel in the RF and foreign states, as well as to characterize the current system of medical care for this category of patients.

HIV Viral Load Monitoring Among Patients Receiving Antiretroviral Therapy - Eight Sub-Saharan Africa Countries, 2013-2018.

One component of the Joint United Nations Programme on HIV/AIDS (UNAIDS) goal to end the HIV/AIDS epidemic by 2030, is that 95% of all persons receiving antiretroviral therapy (ART) achieve viral suppression.† Thus, testing all HIV-positive persons for viral load (number of copies of viral RNA per mL) is a global health priority (1). CDC and other U.S. government agencies, as part of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), together with other stakeholders, have provided technical assistance and supported the cost for multiple countries in sub-Saharan Africa to expand viral load testing as the preferred monitoring strategy for clinical response to ART. The individual and population-level benefits of ART are well understood (2). Persons receiving ART who achieve and sustain an undetectable viral load do not transmit HIV to their sex partners, thereby disrupting onward transmission (2,3). Viral load testing is a cost-effective and sustainable programmatic approach for monitoring treatment success, allowing reduced frequency of health care visits for patients who are virally suppressed (4). Viral load monitoring enables early and accurate detection of treatment failure before immunologic decline. This report describes progress on the scale-up of viral load testing in eight sub-Saharan African countries from 2013 to 2018 and examines the trajectory of improvement with viral load testing scale-up that has paralleled government commitments, sustained technical assistance, and financial resources from international donors. Viral load testing in low- and middle-income countries enables monitoring of viral load suppression at the individual and population level, which is necessary to achieve global epidemic control. Although there has been substantial achievement in improving viral load coverage for all patients receiving ART, continued engagement is needed to reach global targets.

Understating the barriers to achievement of the UNAIDS 90–90–90 goal in Tanzania using a population-based HIV impact assessment survey 2016–2017

ABSTRACT The Joint United Nations Programme on HIV/AIDS (UNAIDS) and partners launched the 90–90–90 targets. We used Tanzania HIV Impact Survey (THIS) data in 2017 to study the barriers to achieve 90-90-90 targets. THIS was a population-based survey with a stratified multistage stage sampling design. We used weighted logistic regression to associate three targets with socio-demographics, HIV-related discrimination, fear and shame. We defined HIV awareness by a combination of self-reported of HIV status positive and detected antiretroviral (ARV) in blood among PLWH. On ARV was defined as those who self-reported among awareness. Viral load suppression was defined as 400 copies/ml or less in the blood sample. The three targets were estimated at 61–90–85 in Tanzania from the weighted analysis. The first target was far from being achieved. The weighted regression showed that being female, having attained higher education, married, having insurance, and living in urban areas were associated with a high likelihood of having ever tested for HIV. The results indicated that intervention programmes in Tanzania should focus on the first target. Intervention programmes should be designed for each target separately. Integrated strategies in the context of low and middle-income countries are needed to achieve these targets.

Knowledge and attitude of secondary school students in Nakaseke, Uganda towards HIV transmission and treatment

Background: One of the major health concerns in Nakaseke district, Uganda is the high prevalence of HIV/AIDS. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), as of March 2014, the prevalence rate of the disease in the district was estimated at about 8%, compared to the national average of 6.5%, making Nakaseke district have the sixth-highest prevalence rate of HIV/AIDS in the entire country. We set out to explore the knowledge and attitude of secondary school students in Nakaseke, Uganda on HIV transmission and treatment. Methods: This was a cross sectional survey-based study with data collected during the month of February 2020. Data were analyzed using R programming language version 3.6.2. Results: A total of 163 participants volunteered for the study, 53.37% males and 46.63% females with ages ranging from 12 – 20 years. Participants came from 5 senior classes (S1, S2, S3, S4 and S6). In total, 87.73% participants were aware of HIV/AIDS while 12.27% were not. The major source of information was through teachers/schools. 96.50% knew the mode of transmission of HIV/AIDS and 95.11% were conversant with HIV/AIDS prevention. 63.6% were aware of the terms DNA and genes whereas 36.36% were not. Discussion: Generally, the students in Nakaseke district, Uganda had a high level of awareness of HIV/AIDS. However, with regards to aspects such as the cause and modern prevention methods like taking prep and prevention of mother to child transmission were less known to them. Efforts to find a cure for HIV/AIDS are still in vain. Therefore, strong emphasis on up to date control and prevention methods should be implemented to fight the HIV/AIDS scourge.

The role of contraception in preventing HIV-positive births: global estimates and projections

BackgroundMeeting the contraceptive needs of women living with HIV (WLHIV) has primary health benefits for women, in addition to being a key element to prevent mother-to-child HIV transmission. This analysis will estimate the current number of infant HIV infections prevented by contraception in the era of increased HIV treatment coverage and; 2) model the additional HIV benefits of preventing unintended births to WLHIV.MethodsSecondary data analysis was conducted using publicly available data from the United Nations Programme on HIV/AIDS (UNAIDS) and Population Division, Demographic Health Surveys, and peer-review literature. National data from 70 countries, that had a UNAIDS estimate for the number of WLHIV nationally, were combined into country-level models. Models estimated the current number of infant HIV infections averted by contraception annually and potentially averted if unintended births to WLHIV were prevented. Estimates take into account pregnancy and live birth rates, contraceptive coverage, contraceptive method mix and failure rates, and HIV treatment coverage during pregnancy to prevent mother to child transmission.ResultsContraception use among WLHIV prevents an estimated 43,559 new infant HIV infections annually across 70 countries. Countries with the largest number of infant infections averted by contraception included South Africa (9441), Nigeria (4195), Kenya (3508), Zimbabwe (2586), and India (2145). Preventing unintended births to WLHIV could avert an additional 43,768 new infant infections per year, with the greatest potential gains to be made in South Africa (12,036), Nigeria (2770), Uganda (2552), and the Democratic Republic of the Congo (2324).ConclusionsContraception continues to play an integral role in global HIV prevention efforts in the era of increasing HIV treatment coverage, especially in sub-Saharan Africa. Broad contraceptive availability, increased contraceptive voluntarism and method mix are key components to preventing unintended births and ending new infant HIV infections worldwide.

Impact of the coronavirus disease 2019-related global recession on the financing of the global HIV response.

Impact of the coronavirus disease 2019-related global recession on the financing of the global HIV response.

Understanding barriers and facilitators to HIV testing in Canada from 2009-2019: A systematic mixed studies review.

HIV testing is a core pillar of Canada's approach to sexually transmitted and blood-borne infection (STBBI) prevention and treatment and is critical to achieving the first Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target. Despite progress toward this goal, many Canadians remain unaware of their status and testing varies across populations and jurisdictions. An understanding of drivers of HIV testing is essential to improve access to HIV testing and reach the undiagnosed. To examine current barriers and facilitators of HIV testing across key populations and jurisdictions in Canada. A systematic mixed studies review of peer-reviewed and grey literature was conducted identifying quantitative and qualitative studies of barriers and facilitators to HIV testing in Canada published from 2009 to 2019. Studies were screened for inclusion and identified barriers and facilitators were extracted. The quality of included studies was assessed and results were summarized. Forty-three relevant studies were identified. Common barriers emerge across key populations and jurisdictions, including difficulties accessing testing services, fear and stigma surrounding HIV, low risk perception, insufficient patient confidentiality and lack of resources for testing. Innovative practices that could facilitate HIV testing were identified, such as new testing settings (dental care, pharmacies, mobile units, emergency departments), new modalities (oral testing, peer counselling) and personalized sex/gender and age-based interventions and approaches. Key populations also face unique sociocultural, structural and legislative barriers to HIV testing. Many studies identified the need to offer a broad range of testing options and integrate testing within routine healthcare practices. Efforts to improve access to HIV testing should consider barriers and facilitators at the level of the individual, healthcare provider and policy and should focus on the accessibility, inclusivity, convenience and confidentiality of testing services. In addition, testing services must be adapted to the unique needs and contexts of key populations.

Prevalence and Associated Factors of HIV Testing Among Pregnant Women: A Multilevel Analysis Using the Recent Demographic and Health Survey Data from 11 East African Countries.

AimIn developing countries, particularly in sub-Saharan Africa, the burden of mother to child transmission (MTCT) of HIV is higher. Although the Joint United Nations Programme on HIV/AIDS (UNAIDS) and other organizations are working to eliminate MTCT, a large number of pregnant women are not screened for HIV in most African countries.MethodsThe demographic health survey (DHS) used two-stage stratified sampling technique to select the study participants and we appended the most recent DHS done in the 11 East African countries. A weighted sample of 53, 420 women were included. A multilevel logistic regression analysis was used due to the hierarchical structure of the DHS data. To determine whether or not there was a clustering, the Interclass Correlation Coefficient (ICC) and Median Odds Ratio (MOR) were determined. Model comparison was conducted using deviance (−2LL).ResultsThe prevalence of HIV testing among pregnant women was 77.56% [95% CI= 77.20%, 77.91%]. In the Multivariable multi-level analysis, variables such as respondent age, wealth index, marital status, educational level, HIV knowledge, HIV stigma indicator, risky sexual activity, women visiting health care facilities, multiple sexual partnership, early sexual initiation, and awareness about MTCT were the individual-level factors that were associated with HIV testing among pregnant women. While residence and community-level education were the community-level factors that were significantly associated with HIV testing.ConclusionThe prevalence of HIV testing and counseling among pregnant women was higher compared to the previous report. Respondent age, wealth index, marital status, educational level, HIV knowledge, HIV stigma indicator, risky sexual activity, women visiting health care facilities, multiple sexual partnership, early sexual initiation, residence, community-level education and awareness about MTCT were the significant determinant of HIV testing.

Data, Principles and Strategies: How Do Global Control Mechanisms on the HIV Epidemic Work?

The article discusses the activities of two United Nations bodies - the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS(UNAIDS) - which are engaged in developing measures to counteract the global HIV/AIDS epidemic. An important component of this activity is gathering information and producing strategic documents. Their almost unclassifiable diversity, however, can be managed by a rigorous algorithm that incorporates data collection, formulation of principles and development of strategies. An analysis of materials such as “reports,” “fact sheets,” and “global strategies” reveals how the main global mechanisms work as they coordinate the efforts of national governments and attempt to control the epidemic globally; analysis also indicates what kind of language is used and what goals are set. In 2020 the ambitious goal of eliminating the HIV/AIDS epidemic by 2030 that is declared in WHO and UNAIDS documents unexpectedly became problematic once more due to the spread of another global epidemic - COVID-19. The publication of new materials on how to continue the fight against HIV/AIDS in the context of the coronavirus pandemic suggests that WHO and UNAIDS are already losing faith in the effectiveness of the measures so far developed in order to eliminate HIV/AIDS. The ongoing crisis caused by the COVID pandemic has also revealed a new trend by converting these UN bodies mostly into tools for producing global information while making other aspects of their activities less visible.

The impact of immigration on tuberculosis and HIV burden between Colombia and Venezuela and across frontier regions.

Historically, human migrations have determined the spread of many infectious diseases by promoting the emergence of temporal outbreaks between populations. We aimed to analyze health indicators, expenditure, and disability caused by tuberculosis (TB) and HIV/AIDS burden under the Colombian-Venezuelan migration flow focusing on the Northeastern border. A retrospective study was conducted using TB and HIV/AIDS data since 2009. We consolidated a database using official reports from the Colombian Surveillance System, World Health Organization, Indexmundi, the Global Health Observatory, IHME HIV atlas, and Joint United Nations Programme on HIV/AIDS (UNAIDS). Disability metrics regarding DALYs (disability adjusted life years) and YLDs (years lived with disability), were compared between countries. Mapping was performed on ArcGIS using official migration data of Venezuelan citizens. Our results indicate that TB profiles from Colombia and Venezuela are identical in terms of disease burden, except for an increase in TB incidence in the Colombian-Venezuelan border departments in recent years, concomitantly with the massive Venezuelan immigration since 2005. We identified a four-fold underfunding for the TB program in Venezuela, which might explain the low-testing rates for cases of multidrug-resistant TB (67%) and HIV/AIDS (60%), as well as extended hospital stays (150 days). We found a significant increase in DALYs of HIV/AIDS patients in Venezuela, specifically, 362.35 compared to 265.37 observed in Colombia during 2017. This study suggests that the Venezuelan massive migration and program underfunding might exacerbate the dual burden of TB and HIV in Colombia, especially towards the Colombian-Venezuelan border.

Use of Trained Non-Medical Staff to Improve Access to HIV Testing Services in Africa: Implementation of the World Health Organization Opt-out Approach in Cameroon.

Background:The Joint United Nations Programme on HIV/AIDS (UNAIDS) in 2019 estimated that 450,000 to 50,000 people in Cameroon were living with HIV, yet only 79% knew their HIV status which is far from the 90% target for 2020. To address this situation, Cameroon adopted the “Opt-out” strategy of the World Health Organization (WHO) and use of trained non-medical cadre (psychosocial agents) to reach out to more people with HIV testing services (HTS). This describes the implementation and outcomes of this strategy by reviewing the activity of a typical day in the Yaoundé Central Hospital (YCH) in Cameroon.Methods:HTS were offered to hospitalized and ambulatory patients (including their companions) in different departments of the YCH. Following screening for recent HIV testing, those with unknown HIV status that gave consent or did not explicitly refuse testing (as per the “Opt-out Strategy”), were counseled and tested for HIV. Testing followed the “National HIV Rapid Testing Algorithm” using rapid diagnostic test kits. Results were either positive, negative or indeterminate. Patients with positive HIV results were linked to the Care and Treatment Center for treatment initiation.Results:Of the 350 patients screened and offered HTS using non-medical cadre (psychosocial agents), 193 (55.1%) were hospitalized and 157 (44.9%) came for outpatient visits. The age of participants ranged from 14 to 92 years and the yield of HIV testing in the sample population was 5.1% (6.2% for hospitalized patients and 3.8% for outpatient clinics). Statistics revealed that five HIV-positive patients had never been offered HTS before the study. The study revealed that HTS acceptance rate among hospitalized patients was 69.6% and that all new positive patients started antiretroviral treatment on the same day.Conclusion and Global Health Implications:It is feasible to use trained non-medical staff for HIV testing services (HTS). Task-shifting by using trained psychosocial agents can help in case identification and linkage to HIV treatment services.

Human Immunodeficiency Virus (HIV) Care Models During the Coronavirus Disease 2019 (COVID-19) Era.

The COVID-19 pandemic is an unprecedented global challenge that substantially risks reversing the progress in ending HIV. At the same time, it may offer the opportunity for a new era of HIV management. This viewpoint presents the impact of COVID-19 on HIV care, including the Joint United Nations Programme on HIV/AIDS (UNAIDS) “three 90s” targets. It outlines how to enhance a patient-centered care approach, now known as the "fourth 90,” by integrating face-to-face patient–physician and telemedicine encounters. It suggests a framework for prevention and treatment of multimorbidity and frailty, to achieve a good health-related quality of life and preserve intrinsic capacity in all people living with HIV.

Wheeling out HIV elimination

HIV Several sub-Saharan countries have been prioritized by the Joint United Nations Programme on HIV/AIDS (UNAIDS) for HIV elimination. This will require 90% treatment coverage by the end of 2030, but poor transport infrastructure means incomplete access to medication in some countries. Palk et al. developed a geospatial model for understanding the difficulties of reaching health care facilities in Malawi, a country severely affected by HIV. They mapped health care facilities with the density of HIV prevalence and quantified the difficulty of travel across Malawi's landscape by a friction surface raster map. If bicycles are used, then the catchment size for a health care facility is substantially larger than if people walk, and the required 90% treatment coverage for elimination becomes achievable. Bicycles are already used as “ambulances” in rural areas, but Malawi's bicycle fleet is small and in poor repair. One straightforward route for beating HIV (and many other health conditions) here and in similar countries could lie simply in boosting the supply of bicycles, an established and well-tested technology. Lancet Glob. Health 8 , E1555 (2020).

High variability in the measurement of HIV primary prevention activities and outcomes.

IntroductionWhile there is a global consensus on monitoring Human Immunodeficiency Virus (HIV) treatment progress, there has been less attention to the degree of consistency of the measurement of HIV prevention programmes—and the global prevention response is not on‐track to achieve 2020 goals. In this paper, we assess the degree of variability in primary prevention indicators selected by national strategic plans (NSPs) and global stakeholder monitoring and evaluation (M&E) strategies.MethodsWe obtained the most recent NSPs from low and middle income Joint United Nations Programme on HIV/AIDS (UNAIDS) Fast‐Track countries, and M&E documents from The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund), President’s Emergency Plan for AIDS Relief (PEPFAR), UNAIDS, the Global HIV Prevention Coalition and the World Health Organization (WHO). We extracted HIV primary prevention indicators from each document, standardized and aggregated them by age/ sex, categorized indicators by topic, and evaluated the frequency of matched indicators between countries and stakeholders. Data were collected between February and April of 2019.ResultsTwenty‐one NSPs and five global stakeholder documents were assessed; 736 primary prevention indicators were identified; 284 remained following standardization and aggregation. NSPs contained from 3 to 48 primary prevention indicators, with an average of 23; categories included: HIV education and outreach (17.6%), testing (17.3%) and condom use (16.2%). Of unique national indicators, only 34% was shared between two or more countries. Sixty‐nine per cent was applied in a single country only. 56% of NSP indicators did not appear in any global stakeholder document. Conversely, 42% of global indicators did not appear in any surveyed NSPs. Within global indicators, 63% was only measured by one global body, and no single indicator was measured by all five.ConclusionsThese analyses reveal a lack of consensus both between and within countries’ and global stakeholders' measurement of HIV prevention. Though some variability is expected, these findings point to a need to refocus attention on achieving greater consensus on a global measurement framework for HIV prevention.

PIN38 Cost-Effectiveness of Expanded HIV Screening Among Adult Population in Italy

The global targets set out by the Joint United Nations Programme on HIV/AIDS (UNAIDS) for 2020 are to diagnose 90% of all HIV-positive people, provide antiretroviral therapy for 90% of those diagnosed, and achieve viral suppression for 90% of those treated (known as 90-90-90 targets). In Italy, there is no uniform HIV screening strategy across the country. Our study aimed to assess the cost-effectiveness of expanded HIV screening among adult population (25-50 years). A decision tree was combined with a previously published Markov model for evaluate the management of HIV-infected patients in Italy. The model was informed by epidemiological and cost estimates taken from different sources (literature and real-world data). The cohort of new HIV diagnosed patients effectively linked to care in Italy (2,847 patients) was followed over a 30-year time horizon evaluating different scenarios for new HIV diagnoses due to the expanded HIV screening. The analysis was conducted from the National Health Service perspective and both costs and QALYs were discounted at an annual rate of 3%. Deterministic and probabilistic sensitivity analysis were conducted to evaluate parameter uncertainty. Our preliminary analysis showed that with an increase of 10% of new HIV linked to care patients, HIV screening strategy resulted in an increment of about 2,466 QALYs and in an increment of about € 73.8 million compared to the status quo from the Italian NHS perspective. The ICER was equal to € 29,943/QALY. Probabilistic sensitivity analysis confirmed that the expanded HIV screening would be cost-effective for > 51% of simulations at a minimum willingness-to-pay threshold of € 30,000 per QALY gained. In Italy there is an urgent need to apply HIV screening strategies to increase awareness of the risks of the disease. Our analysis indicates that the expanded HIV screening in adult population would be cost-effective.

THE INTERNATIONAL GOVERNMENT ORGANIZATIONS ROLE IN GLOBAL HEALTH

International government organizations with a global outreach are working on global health issues to achieve the objective of Health for All. The key actors in global health working on global health problems are the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the Joint United Nations Program on HIV/AIDS (UNAIDS) (Johnson, Stotskopt, & Shi, 2018). These international organizations participate in generating and sharing knowledge, engage in advocacy,provide global funds for health efforts. Our paper will analyze the structure, goals, and processes of global health organizations, UNESCO and UNAIDS.

Assessing barriers to treatment for all: an analysis of resources for PLHA in Cayo and Stann Creek Districts of Belize

Background The Joint United Nations Programme on HIV/AIDS (UNAIDS) launched a global campaign, 90:90:90, which aims to ensure that by 2030: 90% of the people living with HIV will know their HIV status, 90% of those diagnosed with HIV will receive sustained ART, and 90% of those on ART will have durable viral suppression. Belize is striving towards completing this goal and contributing to international efforts for eliminating HIV globally. In order to successfully reach 90% of the population receiving sustained ART, barriers to care that decrease retention rates must be addressed. To combat barriers to care for Persons Living with HIV/AIDS (PLHA), resources must serve to eliminate the obstacles negatively affecting adherence to treatment. Methods This study aimed to (a) assess treatment and care resources in Cayo and Stann Creek districts and (b) pose questions to key informants to gain deeper understanding of HIV services and patient utilization. The study was conducted from May to July 2016 and focused in Belmopan, San Ignacio, and Dangriga to produce an HIV services inventory for the Cayo and Stann Creek districts. Results Our participants composed of 50% civil society and 50% government organizations. 50% of the locations worked less than 45 hours per week and most commonly served the community by providing training, health fairs, and posters. Resources with the lowest number of facility participation were directly observed therapy (DOT), HIV support group (HSG), and prescriptions. The emerging themes from the key informants were (a) concern with patients’ needs, (b) unsustainable resources, and (c) inadequate quality of treatment and care beyond the provider’s control. Results convey the gap between the needs of PLHA and what is being offered by the organizations in the community. In addition, key informants note the unsustainable resources that may contribute to the current climate. Conclusions The final product of this study included a report based on the data produced, a patient-friendly brochure in English listing resources available, and an infographic summarizing the findings of this study.

Written at the closing year of the "three 90%" strategic goal for AIDS prevention and treatment

In 2014, Joint United Nations Programme on HIV/AIDS (UNAIDS) put forward the goal of ending HIV epidemic by 2030 at the International AIDS Conference and proposed the strategic goal of achieving "three 90%" by 2020. This year is the closing year of this strategic goal, and all regions have begun to evaluate the progress of implementing the goal. This article discussed the progress of the implementation of the "three 90%", and scientifically interpreted the strategic goal. It is proposed that the goal is a relative and dynamic concept, and only if we sieze the opportunity to achieve the strategic goal and continuously enhance comprehensive prevention and control, can the HIV epidemic be better controlled.