Evidence map›Paper›PMID 28588933›Full record

ArticleBMJ global health2016

Can the UNAIDS 90-90-90 target be achieved? A systematic analysis of national HIV treatment cascades.

Jacob Levi, Alice Raymond, Anton Pozniak, Pietro Vernazza, Philipp Kohler, Andrew Hill

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In one paragraph

Article in BMJ global health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 166 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
166citing papers in PubMed, 7 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

166 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  3. Acceptability and uptake of HIV self-testing in emergency care settings: A systematic review and meta-analysis.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2022
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106 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jacob LeviSchool of Public Health, Imperial College London, London, UK.
Alice RaymondSchool of Public Health, Imperial College London, London, UK.
Anton PozniakSt Stephen's Centre, Chelsea and Westminster Hospital, London, UK.
Pietro VernazzaDivision of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital, St. Gallen, Switzerland.
Philipp KohlerDivision of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital, St. Gallen, Switzerland.
Andrew HillSt Stephen's Centre, Chelsea and Westminster Hospital, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2014, the Joint United Nations Programme on HIV and AIDS (UNAIDS) and partners set the '90-90-90 targets'; aiming to diagnose 90% of all HIV positive people, provide antiretroviral therapy (ART) for 90% of those diagnosed and achieve viral suppression for 90% of those treated, by 2020. This results in 81% of all HIV positive people on treatment and 73% of all HIV positive people achieving viral suppression. We aimed to analyse how effective national HIV treatment programmes are at meeting these targets, using HIV care continuums or cascades.

methodsWe searched for HIV treatment cascades for 196 countries in published papers, conference presentations, UNAIDS databases and national reports. Cascades were constructed using reliable, generalisable, recent data from national, cross-sectional and longitudinal study cohorts. Data were collected for four stages; total HIV positive people, diagnosed, on treatment and virally suppressed. The cascades were categorised as complete (four stages) or partial (3 stages), and analysed for 'break points' defined as a drop >10% in coverage between consecutive 90-90-90 targets.

results69 country cascades were analysed (32 complete, 37 partial). Diagnosis (target one-90%) ranged from 87% (the Netherlands) to 11% (Yemen). Treatment coverage (target two-81% on ART) ranged from 71% (Switzerland) to 3% (Afghanistan). Viral suppression (target three-73% virally suppressed) was between 68% (Switzerland) and 7% (China).

conclusionsNo country analysed met the 90-90-90 targets. Diagnosis was the greatest break point globally, but the most frequent key break point for individual countries was providing ART to those diagnosed. Large disparities were identified between countries. Without commitment to standardised reporting methodologies, international comparisons are complex.

Identifiers

PMID28588933
PMCPMC5321333

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.