To achieve 95-95-95 targets we must reach men and youth: High level of knowledge of HIV status, ART coverage, and viral suppression in the Botswana Combination Prevention Project through universal test and treat approach.

<h4>Background</h4>Increasing HIV treatment coverage is crucial to reducing population-level HIV incidence.<h4>Methods</h4>The Botswana Combination Prevention Project (BCPP) was a community randomized trial examining the impact of multiple prevention interventions on populati...

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Autores principales: Refeletswe Lebelonyane, Pamela Bachanas, Lisa Block, Faith Ussery, Mary Grace Alwano, Tafireyi Marukutira, Shenaaz El Halabi, Michelle Roland, William Abrams, Gene Ussery, James A Miller, Shahin Lockman, Tendani Gaolathe, Molly Pretorius Holme, Shannon Hader, Lisa A Mills, Kathleen Wirth, Naomi Bock, Janet Moore
Formato: article
Lenguaje:EN
Publicado: Public Library of Science (PLoS) 2021
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Acceso en línea:https://doaj.org/article/3aa07e96339f4258ab69e6c3db81ea42
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Sumario:<h4>Background</h4>Increasing HIV treatment coverage is crucial to reducing population-level HIV incidence.<h4>Methods</h4>The Botswana Combination Prevention Project (BCPP) was a community randomized trial examining the impact of multiple prevention interventions on population-level HIV incidence and was conducted from October 2013 through June 2017. Home and mobile campaigns offered HIV testing to all individuals ≥ age 16. All identified HIV-positive persons who were not on antiretroviral therapy (ART) were referred to treatment and tracked to determine linkage to care, ART status, retention in treatment, and viral suppression.<h4>Results</h4>Of an estimated total of 14,270 people living with HIV (PLHIV) residing in the 15 intervention communities, BCPP identified 13,328 HIV-positive persons (93%). At study start, 10,703 (80%) of estimated PLHIV knew their status; 2,625 (20%) learned their status during BCPP, a 25% increase with the greatest increases occurring among men (37%) and youth (77%). At study start, 9,258 (65%) of estimated PLHIV were on ART. An additional 3,001 persons started ART through the study. By study end, 12,259 had initiated and were retained on ART, increasing coverage to 93%. A greater increase in ART coverage was achieved among men (40%) compared to women (29%). Of the 11,954 persons who had viral load (VL) test results, 11,687 (98%) were virally suppressed (HIV-1 RNA ≤400 copies/mL). Overall, 82% had documented VL suppression by study end.<h4>Conclusions</h4>Knowledge of HIV-positive status and ART coverage increased towards 95-95 targets with universal testing, linkage interventions, and ART. The increases in HIV testing and ART use among men and youth were essential to reaching these targets.<h4>Clinical trial number</h4>NCT01965470.