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Gaps and opportunities: measuring the key population cascade through surveys and services to guide the HIV response

INTRODUCTION: The UNAIDS 90‐90‐90 targets to diagnose 90% of people living with HIV, put 90% of them on treatment, and for 90% of them to have suppressed viral load have focused the international HIV response on the goal of eliminating HIV by 2030. They are also a constructive tool for measuring pro...

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Autores principales: Hakim, Avi Joseph, MacDonald, Virginia, Hladik, Wolfgang, Zhao, Jinkou, Burnett, Janet, Sabin, Keith, Prybylski, Dimitri, Garcia Calleja, Jesus Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055128/
https://www.ncbi.nlm.nih.gov/pubmed/30033654
http://dx.doi.org/10.1002/jia2.25119
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author Hakim, Avi Joseph
MacDonald, Virginia
Hladik, Wolfgang
Zhao, Jinkou
Burnett, Janet
Sabin, Keith
Prybylski, Dimitri
Garcia Calleja, Jesus Maria
author_facet Hakim, Avi Joseph
MacDonald, Virginia
Hladik, Wolfgang
Zhao, Jinkou
Burnett, Janet
Sabin, Keith
Prybylski, Dimitri
Garcia Calleja, Jesus Maria
author_sort Hakim, Avi Joseph
collection PubMed
description INTRODUCTION: The UNAIDS 90‐90‐90 targets to diagnose 90% of people living with HIV, put 90% of them on treatment, and for 90% of them to have suppressed viral load have focused the international HIV response on the goal of eliminating HIV by 2030. They are also a constructive tool for measuring progress toward reaching this goal but their utility is dependent upon data availability. Though more than 25% of new infections are among key populations (KP)‐ sex workers, men who have sex with men, transgender people, people who inject drugs, and prisoners‐ and their sex partners, there is a dearth of treatment cascade data for KP. We assess the availability of cascade data and review the opportunities offered by biobehavioral and programme data to inform the HIV response. DISCUSSION: The emphasis on the collection of treatment cascade data among the general population in higher prevalence countries has not led to a similar increase in the availability of cascade data for KP. The limited data available for KP highlight large gaps in service uptake across the cascade, particularly in the first 90, awareness of HIV status. Biobehavioral surveys (BBS), with linked population size estimation, provide population‐based data on the treatment cascade and should be conducted every two to three years in locations with services for KP. With the inclusion of viral load testing, these surveys are able to monitor the entire treatment cascade among KP regardless of whether these populations access HIV services targeting the general population or KP. BBS also reach people accessing services and those who do not, thereby providing a unique opportunity to learn about barriers to service uptake including stigma and discrimination. At the same time high‐quality programme data can play a complementary role in identifying missed opportunities that can be addressed in real‐time. CONCLUSIONS: Data are more important than ever for guiding the HIV response toward reaching 90‐90‐90 targets and eliminating HIV, particularly in the face of decreased funding for HIV and specifically for KP. Timely high‐quality BBS data can be triangulated with high‐quality programme data to provide a comprehensive picture of the epidemic response for KP.
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spelling pubmed-60551282018-07-30 Gaps and opportunities: measuring the key population cascade through surveys and services to guide the HIV response Hakim, Avi Joseph MacDonald, Virginia Hladik, Wolfgang Zhao, Jinkou Burnett, Janet Sabin, Keith Prybylski, Dimitri Garcia Calleja, Jesus Maria J Int AIDS Soc Commentary INTRODUCTION: The UNAIDS 90‐90‐90 targets to diagnose 90% of people living with HIV, put 90% of them on treatment, and for 90% of them to have suppressed viral load have focused the international HIV response on the goal of eliminating HIV by 2030. They are also a constructive tool for measuring progress toward reaching this goal but their utility is dependent upon data availability. Though more than 25% of new infections are among key populations (KP)‐ sex workers, men who have sex with men, transgender people, people who inject drugs, and prisoners‐ and their sex partners, there is a dearth of treatment cascade data for KP. We assess the availability of cascade data and review the opportunities offered by biobehavioral and programme data to inform the HIV response. DISCUSSION: The emphasis on the collection of treatment cascade data among the general population in higher prevalence countries has not led to a similar increase in the availability of cascade data for KP. The limited data available for KP highlight large gaps in service uptake across the cascade, particularly in the first 90, awareness of HIV status. Biobehavioral surveys (BBS), with linked population size estimation, provide population‐based data on the treatment cascade and should be conducted every two to three years in locations with services for KP. With the inclusion of viral load testing, these surveys are able to monitor the entire treatment cascade among KP regardless of whether these populations access HIV services targeting the general population or KP. BBS also reach people accessing services and those who do not, thereby providing a unique opportunity to learn about barriers to service uptake including stigma and discrimination. At the same time high‐quality programme data can play a complementary role in identifying missed opportunities that can be addressed in real‐time. CONCLUSIONS: Data are more important than ever for guiding the HIV response toward reaching 90‐90‐90 targets and eliminating HIV, particularly in the face of decreased funding for HIV and specifically for KP. Timely high‐quality BBS data can be triangulated with high‐quality programme data to provide a comprehensive picture of the epidemic response for KP. John Wiley and Sons Inc. 2018-07-22 /pmc/articles/PMC6055128/ /pubmed/30033654 http://dx.doi.org/10.1002/jia2.25119 Text en © 2018 World Health Organization; licensee IAS. This is an open access article distributed under the terms of the http://creativecommons.org/licenses/by/4.0/ IGO License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Commentary
Hakim, Avi Joseph
MacDonald, Virginia
Hladik, Wolfgang
Zhao, Jinkou
Burnett, Janet
Sabin, Keith
Prybylski, Dimitri
Garcia Calleja, Jesus Maria
Gaps and opportunities: measuring the key population cascade through surveys and services to guide the HIV response
title Gaps and opportunities: measuring the key population cascade through surveys and services to guide the HIV response
title_full Gaps and opportunities: measuring the key population cascade through surveys and services to guide the HIV response
title_fullStr Gaps and opportunities: measuring the key population cascade through surveys and services to guide the HIV response
title_full_unstemmed Gaps and opportunities: measuring the key population cascade through surveys and services to guide the HIV response
title_short Gaps and opportunities: measuring the key population cascade through surveys and services to guide the HIV response
title_sort gaps and opportunities: measuring the key population cascade through surveys and services to guide the hiv response
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055128/
https://www.ncbi.nlm.nih.gov/pubmed/30033654
http://dx.doi.org/10.1002/jia2.25119
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