Original Research

Progress towards the 2020 targets for HIV diagnosis and antiretroviral treatment in South Africa

Leigh F. Johnson, Rob E. Dorrington, Haroon Moolla
Southern African Journal of HIV Medicine | Vol 18, No 1 | a694 | DOI: https://doi.org/10.4102/sajhivmed.v18i1.694 | © 2017 Leigh F. Johnson, Rob E. Dorrington, Haroon Moolla | This work is licensed under CC Attribution 4.0
Submitted: 21 September 2016 | Published: 27 July 2017

About the author(s)

Leigh F. Johnson, Centre for Infectious Disease Epidemiology and Research, University of Cape Town, South Africa
Rob E. Dorrington, Centre for Actuarial Research, University of Cape Town, South Africa
Haroon Moolla, Centre for Infectious Disease Epidemiology and Research, University of Cape Town, South Africa


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Abstract

Background: The UNAIDS targets for 2020 are to achieve a 90% rate of diagnosis in HIVpositive individuals, to provide antiretroviral treatment (ART) to 90% of HIV-diagnosed individuals and to achieve virological suppression in 90% of ART patients.

Objectives: To assess South Africa’s progress towards the 2020 targets and variations in performance by province.

Methods: A mathematical model was fitted to HIV data for each of South Africa’s provinces, and for the country as a whole. Numbers of HIV tests performed in each province were estimated from routine data over the 2002–2015 period, and numbers of patients receiving ART in each province were estimated by fitting models to reported public and private ART enrolment statistics.

Results: By the middle of 2015, 85.5% (95% CI: 84.5% – 86.5%) of HIV-positive South African adults had been diagnosed, with little variation between provinces. However, only 56.9% (95% CI: 55.3% – 58.7%) of HIV-diagnosed adults were on ART, with this proportion varying between 50.8% in North West and 72.7% in Northern Cape. In addition, 78.4% of adults on ART were virally suppressed, with rates ranging from 69.7% in Limpopo to 85.9% in Western Cape. Overall, 3.39 million (95% CI: 3.26–3.52 million) South Africans were on ART by mid- 2015, equivalent to 48.6% (95% CI: 46.0% – 51.2%) of the HIV-positive population. ART coverage varied between 43.0% in Gauteng and 63.0% in Northern Cape.

Conclusion: Although South Africa is well on its way to reaching the 90% HIV diagnosis target, most provinces face challenges in reaching the remaining two 90% targets.


Keywords

HIV/AIDS; antiretroviral treatment; HIV diagnosis; South Africa

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