Progress in Reversing the HIV Epidemic through Intensified Access to Antiretroviral Therapy: Results from a Nationally Representative Population-Based Survey in Kenya, 2012

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Kim, Andrea A. ; Mukui, Irene ; N’gan’ga, Lucy ; Katana, Abraham ; Koros, Dan ; Wamicwe, Joyce ; De Cock, Kevin M.
• Corporate Authors:
  KAIS Study Group
• Description:
  Background
  
  In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) called for 90% of persons living with HIV (PLHIV) to know their status, 90% of these to be on antiretroviral therapy (ART), and 90% of these to be virally suppressed by 2020 (90-90-90). It is not clear whether planned ART scale-up in countries whose eligibility criteria for ART initiation are based on recommendations from the 2013 World Health Organization treatment guidelines will be sufficient to meet UNAIDS' new global targets.
  
  Materials and Methods
  
  Using data from a nationally representative population-based household survey of persons in Kenya we compared coverage and unmet need associated with HIV diagnosis, ART, and viral suppression among PLHIV aged 15–64 years in 2012 based on criteria outlined in the 2014 national ART guidelines and UNAIDS’ 90-90-90 goals. Estimates were weighted to account for sampling probability and nonresponse.
  
  Results
  
  Eight in ten PLHIV aged 15–64 years needed ART based on treatment eligibility. Need for treatment based on the national treatment policy was 97.4% of treatment need based on UNAIDS’ 90-90-90 goals, requiring an excess of 24,000 PLHIV to access treatment beyond those eligible for ART to achieve UNAIDS’ 90-90-90 treatment target. The gap in treatment coverage was high, ranging from 43.1% nationally to 52.3% in Nyanza among treatment-eligible PLHIV and 44.6% nationally to 52.4% in Nyanza among all PLHIV.
  
  Conclusion
  
  Maintaining the current pace of ART scale-up in Kenya will result in thousands of PLHIV unreached, many with high viral load and at-risk of transmitting infection to others. Careful strategies for reaching 90-90-90 will be instrumental in determining whether intensified access to treatment can be achieved to reach all who require ART.
  
  
• Subjects:
  Adolescent Adult Anti-HIV Agents Epidemics Female Health Care Surveys Health Services Accessibility HIV Infections Humans Male Middle Aged Prevalence Young Adult

  More +
• Source:
  PLoS One. 11(3).
• Pubmed ID:
  26930291
• Pubmed Central ID:
  PMC4773218
• Document Type:
  Journal Article
• Funding:
  GH000069/PEPFAR/United States ; PS001805/PEPFAR/United States ; PS001814/PEPFAR/United States
• Name as Subject:
  United States. President's Emergency Plan For AIDS Relief (PEPFAR)
• Place as Subject:
  Kenya
• Volume:
  11
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:7ea779cfa94ba57225f7731b7bf67eaba34b7e6c85bed119bdaa01426f76f6971c0c8299c46658894896042e7cc458394d4147f0e098b842343ad0b95381c77a
• Download URL:
  https://stacks.cdc.gov/view/cdc/38522/cdc_38522_DS1.pdf
• File Type:
  [PDF - 1.02 MB ]