PMID- 38467135 OWN - NLM STAT- MEDLINE DCOM- 20240329 LR - 20240329 IS - 2352-3018 (Electronic) IS - 2352-3018 (Linking) VI - 11 IP - 4 DP - 2024 Apr TI - Progress towards the UNAIDS 95-95-95 targets in the Fifth Botswana AIDS Impact Survey (BAIS V 2021): a nationally representative survey. PG - e245-e254 LID - S2352-3018(24)00003-1 [pii] LID - 10.1016/S2352-3018(24)00003-1 [doi] AB - BACKGROUND: In 2014, UNAIDS set a goal to end the AIDS epidemic by achieving targets for the percentage of people living with HIV who were aware of their status, on antiretroviral therapy (ART), and virally suppressed. In 2020, these targets were revised to 95% for each measure (known as 95-95-95), to be reached among people living with HIV by 2025. We used data from the Fifth Botswana AIDS Impact Survey (BAIS V) to measure progress towards these testing and treatment targets in Botswana. METHODS: BAIS V used a two-stage cluster design to obtain a nationally representative sample of people aged 15-64 years in Botswana. During March-August, 2021, 14 763 consenting participants were interviewed and tested for HIV in their households by survey teams. HIV-positive specimens were tested for viral load, presence of antiretroviral drugs, and recency of infection using the HIV-1 limiting antigen avidity enzyme immunoassay. Estimates of HIV-positive status and use of ART were based on self-report and the analysis of blood specimens for antiretroviral drugs. Viral load suppression was defined as an HIV RNA concentration of less than 1000 copies per mL. HIV incidence was calculated using the recent infection testing algorithm. Data were weighted to account for the complex survey design. FINDINGS: The national HIV prevalence in Botswana among people aged 15-64 years was 20.8% and the annual incidence of HIV infection was 0.2%. 95.1% (men 93.0%, women 96.4%) of people living with HIV aged 15-64 years were aware of their status, 98.0% (men 97.2%, women 98.4%) of those aware were on ART, and 97.9% (men 96.6%, women 98.6%) of those on ART had viral load suppression. Among young people (aged 15-24 years) living with HIV, 84.5% were aware of their status, 98.5% of those aware were on ART, and 91.6% of those on ART had viral load suppression. The prevalance of viral load suppression among all people living with HIV was 91.8%, and varied by district-ranging from 85.3% in Gaborone to 100.0% in Selibe Phikwe. INTERPRETATION: BAIS V is the first population-based survey worldwide to report the achievement of the UNAIDS 95-95-95 goals, both overall and among women. Strategies to reach undiagnosed men and young people, including young women, are needed. FUNDING: US President's Emergency Plan for AIDS Relief. CI - Copyright (c) 2024 Elsevier Ltd. All rights reserved. FAU - Mine, Madisa AU - Mine M AD - Ministry of Health, Gaborone, Botswana. FAU - Stafford, Kristen A AU - Stafford KA AD - Center for International Health, Education, and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA. FAU - Laws, Rebecca L AU - Laws RL AD - Division of Global HIV and TB, US Centers for Disease Control and Prevention, Atlanta, GA, USA. FAU - Marima, Reson AU - Marima R AD - Botswana University of Maryland School of Medicine Health Initiative (Bummhi), Gaborone, Botswana. FAU - Lekone, Phenyo AU - Lekone P AD - Division of Global HIV and TB, US Centers for Disease Control and Prevention, Gaborone, Botswana. FAU - Ramaabya, Dinah AU - Ramaabya D AD - Ministry of Health, Gaborone, Botswana. FAU - Makhaola, Kgomotso AU - Makhaola K AD - Division of Global HIV and TB, US Centers for Disease Control and Prevention, Gaborone, Botswana. FAU - Patel, Hetal K AU - Patel HK AD - Division of Global HIV and TB, US Centers for Disease Control and Prevention, Atlanta, GA, USA. FAU - Mapondera, Prichard AU - Mapondera P AD - Botswana University of Maryland School of Medicine Health Initiative (Bummhi), Gaborone, Botswana. FAU - Wray-Gordon, Floris AU - Wray-Gordon F AD - Division of Global HIV and TB, US Centers for Disease Control and Prevention, Atlanta, GA, USA. FAU - Agbakwuru, Chinedu AU - Agbakwuru C AD - Center for International Health, Education, and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA. FAU - Okui, Lillian AU - Okui L AD - Botswana University of Maryland School of Medicine Health Initiative (Bummhi), Gaborone, Botswana. FAU - Matroos, Susan AU - Matroos S AD - Statistics Botswana, Gaborone, Botswana. FAU - Onyadile, Eden AU - Onyadile E AD - Statistics Botswana, Gaborone, Botswana. FAU - Ngidi, Julia AU - Ngidi J AD - Ministry of Health, Gaborone, Botswana. FAU - Abimiku, Alash'le AU - Abimiku A AD - Center for International Health, Education, and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA. FAU - Bagapi, Khuteletso AU - Bagapi K AD - Division of Global HIV and TB, US Centers for Disease Control and Prevention, Gaborone, Botswana. FAU - Nkomo, Bornapate AU - Nkomo B AD - Ministry of Health, Gaborone, Botswana. FAU - Bodika, Stephane M AU - Bodika SM AD - Division of Global HIV and TB, US Centers for Disease Control and Prevention, Atlanta, GA, USA. FAU - Kim, Kaylee J AU - Kim KJ AD - Division of Global HIV and TB, US Centers for Disease Control and Prevention, Gaborone, Botswana. FAU - Moloney, Mirna AU - Moloney M AD - Center for International Health, Education, and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA. FAU - Mitchell, Andrew AU - Mitchell A AD - Center for International Health, Education, and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA. FAU - Ehoche, Akipu AU - Ehoche A AD - Center for International Health, Education, and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA. FAU - Ussery, Faith L AU - Ussery FL AD - Division of Global HIV and TB, US Centers for Disease Control and Prevention, Atlanta, GA, USA. FAU - Hong, Steven Y AU - Hong SY AD - Division of Global HIV and TB, US Centers for Disease Control and Prevention, Gaborone, Botswana. FAU - Keipeile, Stella AU - Keipeile S AD - National AIDS and Health Promotion Agency, Gaborone, Botswana. FAU - Matlhaga, Matshelo AU - Matlhaga M AD - National AIDS and Health Promotion Agency, Gaborone, Botswana. FAU - Mathumo, Rapetse AU - Mathumo R AD - National AIDS and Health Promotion Agency, Gaborone, Botswana. FAU - Selato, Robert AU - Selato R AD - National AIDS and Health Promotion Agency, Gaborone, Botswana. FAU - Charurat, Manhattan E AU - Charurat ME AD - Center for International Health, Education, and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA. FAU - Voetsch, Andrew C AU - Voetsch AC AD - Division of Global HIV and TB, US Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: avoetsch@cdc.gov. LA - eng PT - Journal Article DEP - 20240308 PL - Netherlands TA - Lancet HIV JT - The lancet. HIV JID - 101645355 RN - 0 (Anti-Retroviral Agents) SB - IM MH - Male MH - Humans MH - Female MH - Adolescent MH - *Acquired Immunodeficiency Syndrome/drug therapy/epidemiology MH - *HIV Infections/drug therapy/epidemiology MH - Botswana/epidemiology MH - Anti-Retroviral Agents/therapeutic use MH - Surveys and Questionnaires MH - Viral Load MH - Prevalence COIS- Declaration of interests We declare no competing interests. EDAT- 2024/03/12 00:42 MHDA- 2024/03/29 06:46 CRDT- 2024/03/11 19:52 PHST- 2023/05/11 00:00 [received] PHST- 2023/12/18 00:00 [revised] PHST- 2024/01/03 00:00 [accepted] PHST- 2024/03/29 06:46 [medline] PHST- 2024/03/12 00:42 [pubmed] PHST- 2024/03/11 19:52 [entrez] AID - S2352-3018(24)00003-1 [pii] AID - 10.1016/S2352-3018(24)00003-1 [doi] PST - ppublish SO - Lancet HIV. 2024 Apr;11(4):e245-e254. doi: 10.1016/S2352-3018(24)00003-1. Epub 2024 Mar 8.