Bridge the gap
Since most nations could not meet 2020 AIDS targets, now the eyes are set on 2030 goalpost of 95-95-95 targets (95% of people living with HIV to know their status, 95% of them should be on ART, and 95% of these be virally suppressed). HIV self-test is one of the key cog-in-the-wheel to "reaching out to the last mile" for first-95 target.
Globally, 85% of all people living with HIV knew their HIV status in 2021. Among people who knew their status, 88% were accessing treatment. And among people accessing treatment, 92% were virally suppressed. In other words of all people living with HIV 85% knew their status, 75% were accessing treatment and 68% were virally suppressed in 2021.
In India, as on March 2022, 77% of people living with HIV knew their status, 84% of them were on antiretroviral therapy, and 85% of them had viral suppression. This translates into 55% of total people living with HIV in India being virally suppressed in 2021-22 against the target of getting 86% of them virally suppressed by 2025-26.
According to Government of India's National AIDS Control Organization 2022 report, between 2010 and 2021, new infections declined by 46% whereas the goal was to reduce new HIV infections by 80% by 2025 - clearly we need to do a lot more to turn the tide.
Key populations cannot be left behind
While the overall adult prevalence remains low (0.21% in 2021), HIV prevalence among high-risk groups and the bridge population remains very high. HIV prevalence among migrants is 4 times, among truckers is 5 times, among inmates in central jails and female sex workers is 9 times, among men who have sex with men (MSM) is 16 times, among hijra/transgender people is 18 times and among people who use drugs is 43 times of the overall adult HIV prevalence.
The studies presented at International Conference on Retroviruses and Opportunistic Infections (CROI 2022) showed that even virtual approaches provided an additional entry point to increase uptake of HIV testing in those who are currently getting missed by traditional healthcare services - especially those from key populations. PATH report launched in 2022 showed HIV self-testing is acceptable to key populations and their partners in India.
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