@article{fdi:010071788,
  title = {{P}rogress toward the {UNAIDS} 90-90-90 goals by age and gender in a rural area of {K}wa{Z}ulu-{N}atal, {S}outh {A}frica : a household-based community cross-sectional survey},
  author = {{H}uerga, {H}. and {V}an {C}utsem, {G}. and {B}en {F}arhat, {J}. and {P}uren, {A}. and {B}ouhenia, {M}. and {W}iesner, {L}. and {D}lamini, {L}. and {M}aman, {D}. and {E}llman, {T}. and {E}tard, {J}ean-{F}ran{\c{c}}ois},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {T}he {J}oint {U}nited {N}ations {P}rogramme on {HIV}/{AIDS} ({UNAIDS}) has developed an ambitious strategy to end the {AIDS} epidemic. {A}fter eight years of antiretroviral therapy ({ART}) program we assessed progress towards the {UNAIDS} 90-90-90 targets in {M}bongolwane and {E}showe, {K}wa{Z}ulu-{N}atal, {S}outh {A}frica. {M}ethods: {W}e conducted a cross-sectional household-based community survey using a two-stage stratified cluster probability sampling strategy. {P}ersons aged 15-59 years were eligible. {W}e used face-to-face interviewer-administered questionnaires to collect information on history of {HIV} testing and care. {R}apid {HIV} testing was performed on site and venous blood specimens collected from {HIV}-positive participants for antiretroviral drug presence test, {CD}4 count and viral load. {A}t the time of the survey the {CD}4 threshold for {ART} initiation was 350 cells/μ{L}. {W}e calculated progression towards the 90-90-90 {UNAIDS} targets by estimating three proportions: {HIV} positive individuals who knew their status (first 90), those diagnosed who were on {ART} (second 90), and those on {ART} who were virally suppressed (third 90). {R}esults: {W}e included 5649/6688 (84.5%) individuals. {M}edian age was 26 years ({IQR}: 19-40), 62.3% were women. {HIV} prevalence was 25.2% (95% {CI}: 23.6-26.9): 30.9% (95% {CI}: 29.0-32.9) in women; 15.9% (95% {CI}: 14.0-18.0) in men. {O}verall progress towards the 90-90-90 targets was as follows: 76.4% (95% {CI}: 74.1-78.6) knew their status, 69.9% (95% {CI}: 67.0-72.7) of those who knew their status were on {ART} and 93.1% (95% {CI}: 91.0-94.8) of those on {ART} were virally suppressed. {B}y sex, progress towards the 90-90-90 targets was: 79%-71%-93% among women; and 68%-68%-92% among men (p-values of women and men comparisons were < 0.001, 0.443 and 0.584 respectively). {B}y age, progress was: 83%-75%-95% among individuals aged 30-59 years and 64%-58%-89% among those aged 15-29 years (p-values of age groups comparisons were < 0.001, < 0.001 and 0.011 respectively). {C}onclusions: {I}n this context of high {HIV} prevalence, significant progress has been achieved with regards to reaching the {UNAIDS} 90-90-90 targets. {T}he third 90, viral suppression in people on {ART}, was achieved among women and men. {H}owever, gaps persist in {HIV} diagnosis and {ART} coverage particularly in men and individuals younger than 30 years. {A}chieving 90-90-90 is feasible but requires additional investment to reach youth and men.},
  keywords = {{SIDA} ; {PREVALENCE} ; {TRAITEMENT} {MEDICAL} ; {SANTE} {PUBLIQUE} ; {POPULATION} {RURALE} ; {SEX} {RATIO} ; {AGE} {PHYSIOLOGIQUE} ; {ENQUETE} ; {AFRIQUE} {DU} {SUD} ; {NATAL} ; {KWAZULU} ; {MBONGOLWANE} ; {ESHOWE}},
  booktitle = {},
  journal = {{BMC} {P}ublic {H}ealth},
  volume = {18},
  numero = {},
  pages = {art. no 303 [8  en ligne]},
  ISSN = {1471-2458},
  year = {2018},
  DOI = {10.1186/s12889-018-5208-0},
  URL = {https://www.documentation.ird.fr/hor/fdi:010071788},
}