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. 2024 Oct;29(42):2400058.
doi: 10.2807/1560-7917.ES.2024.29.42.2400058.

Sweden surpasses the UNAIDS 95-95-95 target: estimating HIV-1 incidence, 2003 to 2022

Erik Lundgren  1   2 , Macauley Locke  1   2 , Ethan Romero-Severson  2 , Mira Dimitrijevic  2 , Maria Axelsson  3 , Emmi Andersson  4   3 , Christina Carlander  5   6   4 , Johanna Brännström  7   8   4 , Hans Norrgren  9 , Fredrik Mansson  10 , Olof Elvstam  11   10 , Magnus Gisslén  12   13   3 , Lisa Fohlin  14 , Anders Sönnerborg  4 , Jan Albert  15   16 , Thomas Leitner  2
Affiliations

Sweden surpasses the UNAIDS 95-95-95 target: estimating HIV-1 incidence, 2003 to 2022

Erik Lundgren et al. Euro Surveill. 2024 Oct.

Abstract

BackgroundSweden reached the UNAIDS 90-90-90 target in 2015. It is important to reassess the HIV epidemiological situation due to ever-changing migration patterns, the roll-out of PrEP and the impact of the COVID-19 pandemic.AimWe aimed to assess the progress towards the UNAIDS 95-95-95 targets in Sweden by estimating the proportion of undiagnosed people with HIV (PWHIV) and HIV incidence trends.MethodsWe used routine laboratory data to inform a biomarker model of time since infection. When available, we used previous negative test dates, arrival dates for PWHIV from abroad and transmission modes to inform our incidence model. We also used data collected from the Swedish InfCareHIV register on antiretroviral therapy (ART).ResultsThe yearly incidence of HIV in Sweden decreased after 2014. In part, this was because the fraction of undiagnosed PWHIV had decreased almost twofold since 2006. After 2015, three of four PWHIV in Sweden were diagnosed within 1.9 and 3.2 years after infection among men who have sex with men and in heterosexual groups, respectively. While 80% of new PWHIV in Sweden acquired HIV before immigration, they make up 50% of the current PWHIV in Sweden. By 2022, 96% of all PWHIV in Sweden had been diagnosed, and 99% of them were on ART, with 98% virally suppressed.ConclusionsBy 2022, about half of all PWHIV in Sweden acquired HIV abroad. Using our new biomarker model, we assess that Sweden has reached the UNAIDS goal at 96-99-98.

Keywords: HIV; UNAIDS; biomarkers; incidence; modelling.

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Conflict of interest statement

Conflict of interest: JB has received research grants from Gilead Sciences and honoraria as scientific advisor from Gilead Sciences, GlaxoSmithKline/ViiV, and MSD, all outside the scope of this project; MG has received research grants from Gilead Sciences and honoraria as speaker, DSMB committee member and/or scientific advisor from Amgen, AstraZeneca, Biogen, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline/ViiV, Janssen-Cilag, MSD, Novocure, Novo Nordic, Pfizer and Sanofi, all outside the scope of this project; CC has received research grants from Gilead Sciences and honorarias as speaker and scientific advisor from Gilead Sciences, GlaxoSmithKline/ViiV, and MSD, all outside the scope of this project; OE has received honoraria as speaker from Gilead Sciences, unrelated to this work. All other authors none.

Figures

Figure 1
Figure 1
Estimated yearly incidence and current number of infected individuals, by mode of transmission, Sweden, 2003–2022
Figure 2
Figure 2
Yearly estimated number of undiagnosed PWHIV in Sweden between 2003 and 2022
Figure 3
Figure 3
Number of endogenous actual diagnoses and the estimated mean time from infection per year, Sweden, 2003–2022 (n = 2,117)
Figure 4
Figure 4
Progress towards the UNAIDS 95–95–95 goals in Sweden, 2003–2022
See this image and copyright information in PMC

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