Imperial College London
Alternate

Jeff Imai-Eaton

Faculty of Medicine, School of Public Health

Senior Research Fellow
 
 
 
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Contact

 

jeffrey.eaton

 
 
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Location

 

UG7Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Giguere:2021:10.1016/S2352-3018(20)30315-5,
author = {Giguere, K and Eaton, J and Marsh, K and Johnson, L and Johnson, CC and Ehui, E and Jahn, A and Wanyeki, I and Mbofana, F and Bakiono, F and Mahy, M and Maheu-Giroux, M},
doi = {10.1016/S2352-3018(20)30315-5},
journal = {The Lancet HIV},
pages = {284--293},
title = {Trends in knowledge of HIV status and efficiency of HIV testing services in sub-Saharan Africa, 2000-20: a modelling study using survey and HIV testing programme data},
url = {http://dx.doi.org/10.1016/S2352-3018(20)30315-5},
volume = {8},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Monitoring knowledge of HIV status (KOS) among people living with HIV (PLHIV) is essential for an effective national HIV response. This study estimates progress and gaps in reaching the UNAIDS 2020 target of 90% KOS, and the efficiency of HIV testing services (HTS) in sub-Saharan Africa (SSA), where two thirds of all PLHIV live. Methods: We used data from 183 population-based surveys (N=2·7 million participants) and national HTS programs (N=315 country-years) from 40 countries as inputs into a mathematical model to examine trends in KOS among PLHIV, median time from HIV infection to diagnosis, HIV testing positivity, and proportion of new diagnoses among all positive tests, adjusting for retesting.Findings: Across SSA, KOS steadily increased from 6% (95% credible interval [95%CrI]: 5% to 7%) in 2000 to 84% (95%CrI: 82% to 86%) in 2020. Twelve countries and one region, Southern Africa, reached the 90% target. In 2020, KOS was lower among men (79%) than women (87%) across SSA. PLHIV aged 15-24 years were the least likely to know their status (65%), but the largest gap in terms of absolute numbers was among men aged 35-49 years, with over 700,000 left undiagnosed. As KOS increased from 2000 to 2020, the median time to diagnosis decreased from 10 to 3 years, HIV testing positivity declined from 9% to 3%, and the proportion of first-time diagnoses among all positive tests dropped from 89% to 42%.Interpretation: On the path towards the next UNAIDS target of 95% diagnostic coverage by 2030, and in a context of declining positivity and yield of first-time diagnoses, we need to focus on addressing disparities in KOS. Increasing KOS and treatment coverage among older men could be critical to reduce HIV incidence among women in SSA, and by extension, reducing mother-to-child transmission.
AU  - Giguere,K
AU  - Eaton,J
AU  - Marsh,K
AU  - Johnson,L
AU  - Johnson,CC
AU  - Ehui,E
AU  - Jahn,A
AU  - Wanyeki,I
AU  - Mbofana,F
AU  - Bakiono,F
AU  - Mahy,M
AU  - Maheu-Giroux,M
DO  - 10.1016/S2352-3018(20)30315-5
EP  - 293
PY  - 2021///
SN  - 2405-4704
SP  - 284
TI  - Trends in knowledge of HIV status and efficiency of HIV testing services in sub-Saharan Africa, 2000-20: a modelling study using survey and HIV testing programme data
T2  - The Lancet HIV
UR  - http://dx.doi.org/10.1016/S2352-3018(20)30315-5
UR  - https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(20)30315-5/fulltext
UR  - http://hdl.handle.net/10044/1/84970
VL  - 8
ER  -
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