- A Canadian study monitored more than 1,400 women living with HIV.
- Nearly 30% of women diagnosed with HIV did not achieve viral suppression.
- Some groups of women had greater challenges with adherence and staying in care.
Studies of people who are starting HIV treatment (ART) have found that when ART is taken as directed for several months the amount of HIV in the blood usually falls to very low levels (commonly referred to as an undetectable viral load). Continued use of ART keeps HIV suppressed and studies have found that the health of the immune system gradually improves and the risk of AIDS-related infections and cancers is significantly reduced. The impact of ART is so profound that researchers increasingly expect that many ART users will have a near-normal life expectancy. Studies have also found that ART users who achieve and maintain an undetectable viral load do not pass on HIV during sex.
These twin benefits of ART are so tremendous that the Joint United Nations Program on AIDS (UNAIDS) and the World Health Organization (WHO) have encouraged countries, regions and cities to achieve the following goals by the year 2020:
- 90% of people with HIV know their infection status
- 90% of people diagnosed with HIV have received an offer of and are taking ART
- 90% of ART users have an undetectable viral load
These goals are commonly called “90-90-90.”
The movement of people from HIV testing through taking ART and achieving an undetectable viral load has been given several names by different researchers: the cascade of care, the HIV cascade of care or, simply, the cascade. The term 90-90-90 shortens and idealizes what is, in reality, a complex flow of people in and sometimes out of the healthcare system.