African study exceeds U.N. 'test and treat' goal for ending HIV pandemic

NAIROBI (Thomson Reuters Foundation) - A U.N. goal to get seven out of 10 HIV positive people to take a test, start medication and suppress the deadly virus in their blood is achievable, a study in East Africa showed on Wednesday, raising hopes of ending the AIDS pandemic.

A nurse (L) hands out a red ribbon to a woman, to mark World Aids Day, at the entrance of Emilio Ribas Hospital, in Sao Paulo December 1, 2014. REUTERS/Nacho Doce

Almost 80,000 adults in Uganda and Kenya took part in the study, which used community campaigns, free testing and tests at home to encourage people to know their HIV status and get treatment.

After the intervention, 81 percent of people with HIV had an undetectable viral load, because they tested, initiated medication and adhered to it successfully, up from 45 percent two years earlier.

“It is very promising,” one of the lead researchers, Maya Petersen of the University of California, told the Thomson Reuters Foundation.

“We reached most HIV positive people in these communities.”

UNAIDS, the U.N. agency dealing with the disease, has unveiled ambitious targets to tackle the epidemic.

By 2020, it wants 90 percent of people with HIV to know their status, 90 percent of diagnosed people to be on treatment, and 90 percent of those on treatment to have suppressed levels of the virus in their bodies.

This translates to 73 percent of all people with HIV having an undetectable viral load.

Pointing to the results of the study in Uganda and Kenya, Petersen said it was possible to meet the 90-90-90 UNAIDS targets within a relatively short period.

“Over two years ... communities went from substantially below the United Nations target to achieving it,” Petersen said by phone from Durban in South Africa where the results were released at the International AIDS Conference.


Scaling up HIV treatment in developing countries is of key concern to the experts meeting in South Africa.

Only 17 million of the 36.7 million HIV positive people around the world are taking antiretroviral treatment.

New infections, at 2.1 million in 2015, still exceed the number of people starting antiretroviral treatment each year, Chris Beyrer, president of the International AIDS Society said.

One of the main problems is that people do not know they are HIV positive because of the stigma around testing.

Researchers have tried to address this by setting up large tents in public spaces where people could get tested free of charge for malaria, hypertension and diabetes as well as HIV, Petersen said.

By the shores of Lake Victoria, which has the highest prevalence rates in Kenya, tests were offered on the beach at night so that fishermen, who sleep during the day, could attend.

Using a baseline household census, researchers then visited the homes of community members who had not come for testing and offered them a test.

Nearly half of those who tested newly positive started ART within a week, Petersen said, as they were introduced to and welcomed by local clinic staff immediately.

HIV/AIDS is the main cause of death among 10- to 19-year-olds in Africa, UNAIDS says.

Yet young people proved to be one of the hardest groups to reach with testing and treatment, particularly students who move away from home to attend school and do not want their classmates to see them taking medication, the study found.

The second phase of the study will look at new ways of reaching such groups, Petersen said.