Dozens of African countries unlikely to meet goals for HIV testing, condom use

Dozens of African countries have made limited progress and are unlikely to meet UNAIDS targets for HIV testing and condom use by 2030, researchers reported at the HIV Research for Prevention virtual conference.

Phuong Nguyen, a PhD candidate at St. Luke’s International University Graduate School of Public Health in Tokyo, and colleagues assessed survey data from more than 1.4 million sexually active individuals aged between 15 and 49 years in 38 African countries from 2003 to 2018 and used modeling to estimate what the prevalence of annual HIV testing and condom use will be for every country and year through 2030. The UNIADS target is 95% coverage for both.

“Condom use and HIV testing are the key paths of treatment as prevention strategies, and I actually think [hitting the] targets for these strategies is essential to eliminate HIV in Africa,” Nguyen said during a press conference.

Indeed, a UNAIDS report published last year said condoms “remain a cornerstone of effective prevention programming,” but that investments and programming for condoms “remain suboptimal.”

According to Nguyen and colleagues, seven countries have actually experienced downward trends in annual HIV testing and five saw decreasing trends in condom use.

Their model estimated that the highest coverage of annual HIV testing by 2030 would be in Swaziland at (92.6%; 95% CI, 74.5%-98.1%), Uganda (90.5%; 95% CI, 72.2%-97.2%) and Lesotho (90.5%; 95% CI, 69.4%-97.6%).

The highest coverage rates by 2030 for condom use are predicted to occur in Swaziland (85%; 95% CI, 57.8%-96.1%), Lesotho 75.6%; 95% CI, 42.3%-93.6%) and Namibia (75.5%; 95% CI, 42.4%-93.2%).

According to Nguyen and colleagues, the probability of reaching UNAIDS targets ranges from 0% to 28.5% for HIV testing and 0% to 12.1% for condom use among all countries. No country showed a probability of more than 50% for meeting either target.

“It's important to revise national policy, relocate the national resources and renew attention and support from global funders, especially in the most affected countries,” Nguyen said.

References:

UNAIDS. Progress towards the Start Free, Stay Free, AIDS Free targets: 2020 report. https://www.unaids.org/en/resources/documents/2020/start-free-stay-free-aids-free-2020-progress-report. Accessed Jan. 26, 2020.