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. 2024 Apr;11(4):e245-e254.
doi: 10.1016/S2352-3018(24)00003-1. Epub 2024 Mar 8.

Progress towards the UNAIDS 95-95-95 targets in the Fifth Botswana AIDS Impact Survey (BAIS V 2021): a nationally representative survey

Madisa Mine  1 , Kristen A Stafford  2 , Rebecca L Laws  3 , Reson Marima  4 , Phenyo Lekone  5 , Dinah Ramaabya  1 , Kgomotso Makhaola  5 , Hetal K Patel  3 , Prichard Mapondera  4 , Floris Wray-Gordon  3 , Chinedu Agbakwuru  2 , Lillian Okui  4 , Susan Matroos  6 , Eden Onyadile  6 , Julia Ngidi  1 , Alash'le Abimiku  2 , Khuteletso Bagapi  5 , Bornapate Nkomo  1 , Stephane M Bodika  3 , Kaylee J Kim  5 , Mirna Moloney  2 , Andrew Mitchell  2 , Akipu Ehoche  2 , Faith L Ussery  3 , Steven Y Hong  5 , Stella Keipeile  7 , Matshelo Matlhaga  7 , Rapetse Mathumo  7 , Robert Selato  7 , Manhattan E Charurat  2 , Andrew C Voetsch  8
Affiliations

Progress towards the UNAIDS 95-95-95 targets in the Fifth Botswana AIDS Impact Survey (BAIS V 2021): a nationally representative survey

Madisa Mine et al. Lancet HIV. 2024 Apr.

Abstract

Background: In 2014, UNAIDS set a goal to end the AIDS epidemic by achieving targets for the percentage of people living with HIV who were aware of their status, on antiretroviral therapy (ART), and virally suppressed. In 2020, these targets were revised to 95% for each measure (known as 95-95-95), to be reached among people living with HIV by 2025. We used data from the Fifth Botswana AIDS Impact Survey (BAIS V) to measure progress towards these testing and treatment targets in Botswana.

Methods: BAIS V used a two-stage cluster design to obtain a nationally representative sample of people aged 15-64 years in Botswana. During March-August, 2021, 14 763 consenting participants were interviewed and tested for HIV in their households by survey teams. HIV-positive specimens were tested for viral load, presence of antiretroviral drugs, and recency of infection using the HIV-1 limiting antigen avidity enzyme immunoassay. Estimates of HIV-positive status and use of ART were based on self-report and the analysis of blood specimens for antiretroviral drugs. Viral load suppression was defined as an HIV RNA concentration of less than 1000 copies per mL. HIV incidence was calculated using the recent infection testing algorithm. Data were weighted to account for the complex survey design.

Findings: The national HIV prevalence in Botswana among people aged 15-64 years was 20·8% and the annual incidence of HIV infection was 0·2%. 95·1% (men 93·0%, women 96·4%) of people living with HIV aged 15-64 years were aware of their status, 98·0% (men 97·2%, women 98·4%) of those aware were on ART, and 97·9% (men 96·6%, women 98·6%) of those on ART had viral load suppression. Among young people (aged 15-24 years) living with HIV, 84·5% were aware of their status, 98·5% of those aware were on ART, and 91·6% of those on ART had viral load suppression. The prevalance of viral load suppression among all people living with HIV was 91·8%, and varied by district-ranging from 85·3% in Gaborone to 100·0% in Selibe Phikwe.

Interpretation: BAIS V is the first population-based survey worldwide to report the achievement of the UNAIDS 95-95-95 goals, both overall and among women. Strategies to reach undiagnosed men and young people, including young women, are needed.

Funding: US President's Emergency Plan for AIDS Relief.

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Conflict of interest statement

Declaration of interests We declare no competing interests.

Figures

Figure 1:
Figure 1:
HIV prevalence and viral load suppression among people aged 15–64 years living with HIV in Botswana by district
Figure 2:
Figure 2:. Progress towards the UNAIDS 95-95-95 targets in Botswana by gender
The UNAIDS 95-95-95 targets among people living with HIV aged 15–64 years are based on self-reported HIV status and ART use, both adjusted for having a detectable antiretroviral drug in the blood. Percentages refer to the conditional 95-95-95 targets. The heights of the bars represent the unconditional percentages for each indicator among all people living with HIV. Error bars are 95% CIs. ART=antiretroviral therapy.
Figure 3:
Figure 3:
Progress towards the UNAIDS 95-95-95 targets in Botswana by district
See this image and copyright information in PMC

References

    1. UNAIDS. UNAIDS data 2021. Nov 29, 2021. https://www.unaids.org/en/resources/documents/2021/2021_unaids_data (accessed Dec 12, 2023).
    1. Ramogola-Masire D, Poku O, Mazhani L, et al. Botswana’s HIV response: policies, context, and future directions. J Community Psychol 2020; 48: 1066–70. - PMC - PubMed
    1. Macrotrends. Botswana life expectancy 1950–2022. https://www.macrotrends.net/countries/BWA/botswana/life-expectancy (accessed Dec 12, 2023).
    1. UNAIDS. 90-90-90: an ambitious treatment target to help end the AIDS epidemic. October, 2014. https://www.unaids.org/sites/default/files/media_asset/90-90-90_en.pdf (accessed Dec 12, 2023).
    1. Gaolathe T, Wirth KE, Holme MP, et al. Botswana’s progress toward achieving the 2020 UNAIDS 90-90-90 antiretroviral therapy and virological suppression goals: a population-based survey. Lancet HIV 2016; 3: e221–30. - PMC - PubMed

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