What are the 90 90 90 Targets?
The
90 90 90 targets are a set of ambitious treatment goals established by the [Joint United Nations Programme on HIV/AIDS (UNAIDS)] to help end the global [HIV/AIDS] epidemic. These targets aim to ensure that by 2020, 90% of all people living with HIV will know their HIV status, 90% of all people diagnosed with HIV will receive sustained antiretroviral therapy (ART), and 90% of all people receiving ART will have viral suppression.
Why were the 90 90 90 Targets Established?
The targets were established to accelerate the response to the HIV epidemic and to ensure that the benefits of HIV treatment are maximized. By achieving these targets, it is believed that the spread of HIV can be significantly reduced, and the quality of life for people living with HIV can be improved. The ultimate goal is to bring the epidemic under control by making HIV a manageable chronic condition, akin to diabetes or hypertension.
How are the 90 90 90 Targets Measured?
The progress towards the 90 90 90 targets is measured using a cascade model, which tracks the continuum of care for people living with HIV. This involves:
1.
HIV Testing and Diagnosis: The first 90 refers to the percentage of all people living with HIV who have been diagnosed.
2.
Access to Antiretroviral Therapy: The second 90 indicates the percentage of diagnosed individuals who are receiving sustained ART.
3.
Viral Load Suppression: The third 90 reflects the percentage of individuals on ART who have achieved viral suppression, meaning the virus is undetectable in their blood.
What is the Significance of Viral Load Suppression?
Achieving viral load suppression is crucial because it means that the virus is effectively controlled, reducing the risk of transmission to others. Individuals with suppressed viral loads have a significantly lower chance of developing AIDS-related illnesses, leading to better health outcomes and longevity. Viral suppression also reduces the risk of HIV transmission to sexual partners, contributing to the broader public health goal of reducing new HIV infections.
Challenges in Achieving 90 90 90 Targets
Despite the clear benefits, several challenges hinder the achievement of the 90 90 90 targets:
- Stigma and Discrimination: These remain significant barriers to HIV testing and treatment. Many people avoid getting tested or seeking treatment due to fear of stigma.
- Access to Healthcare: In many low- and middle-income countries, limited access to healthcare services and ART presents a major challenge.
- Retention in Care: Ensuring that individuals remain in care and continue to adhere to their treatment regimen is critical but often challenging.
- Data Collection and Reporting: Accurate data collection is essential for monitoring progress, but many regions face difficulties in maintaining reliable health records.Successful Strategies to Achieve 90 90 90 Targets
Various strategies have proven effective in working towards the 90 90 90 targets, including:
- Community-Based Testing: Bringing HIV testing services to the community helps reach more people and reduces the stigma associated with visiting a clinic.
- Task Shifting: Training non-specialist healthcare workers to provide HIV services can help alleviate the burden on healthcare systems and improve access to ART.
- Enhanced Adherence Support: Providing support mechanisms such as counseling, reminder systems, and peer support groups can help individuals adhere to their treatment plans.
- Integration of Services: Integrating HIV services with other health services such as maternal and child health can help identify and treat more people.The Future Beyond 90 90 90
While the original 2020 targets have been a driving force, ongoing efforts are needed to sustain and build upon these gains. UNAIDS has proposed new targets known as the 95 95 95 targets to be achieved by 2030. These new targets aim for 95% of people living with HIV knowing their status, 95% of those diagnosed receiving ART, and 95% of those on ART achieving viral suppression. The continued focus on addressing barriers and implementing successful strategies will be crucial in achieving these new targets and ultimately ending the HIV epidemic.
