Progress toward HIV epidemic control in Lesotho. (1st December 2019)

• Record Type: Journal Article
• Authors: Thin, Kyaw; Frederix, Koen; McCracken, Stephen; Letsie, Mosilinyane; Low, Andrea; Patel, Hetal; Parekh, Bharat; Motsoane, Tsietso; Ahmed, Nahima; Justman, Jessica; Callaghan, Larkin; Tembo, Susan; Schwitters, Amee
• Is Part Of: AIDS. Volume 33:Number 15(2019)
• Publication Date: 2019-12-01
• Subjects: Africa -- ART -- HIV -- Lesotho -- survey -- viral load suppression; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000002351
• Languages: English
• ISSNs: 0269-9370

Abstract

Abstract : Objective: The Lesotho Population-based HIV Impact Assessment survey was conducted nationally and designed to measure HIV prevalence, incidence, and viral load suppression (VLS). Design: A nationally representative sample of 9403 eligible households was surveyed between November 2016 and May 2017; analyses account for study design. Consenting participants provided blood samples, socio-demographic, and behavioral information. Methods: Blood samples were tested using the national rapid HIV testing algorithm. HIV-seropositive results were confirmed with Geenius supplemental assay. Screening for detectable concentrations of antiretroviral analytes was conducted on dried blood specimens from all HIV-positive adults using high-resolution liquid chromatography coupled with tandem mass spectrometry. Self-reported and/or antiretroviral biomarker data were used to classify individuals as HIV-positive and on treatment. Viral load testing was performed on all HIV-positive samples at central labs. VLS was defined as HIV RNA below 1000 copies/ml. Results: Overall, 25.6% of adults aged 15–59 years were HIV-positive. Among seropositive adults, 81.0% (male 76.6%, female 84.0%) reported knowing their HIV status, 91.8% of people living with HIV (male 91.6%, female 92.0%) who reported knowing their status reporting taking antiretrovirals, and 87.7% (male and female 87.7%) of these had VLS. Younger age was significantly associated with being less likely to be aware of HIV status for both sexes. Conclusions: Findings from this population-based survey provide encouraging data in terms of HIV testing and treatment uptake and coverage. Specific attention to reaching youth to engage them in HIV-related interventions are critical to achieving epidemic control.