Optimizing the HIV Care Environment: A Human Rights Imperative

published on March 16, 2016 by José M. Zuniga, PhD, MPH, in Medscape

Twenty years after the introduction of maximally suppressive antiretroviral therapy (ART), we have an opportunity to reduce the morbidity and mortality associated with HIV infection and to virtually end HIV transmission. In addition to extending survival and preserving quality of life, ART has been proven highly effective in preventing sexual, parenteral, and vertical HIV transmission. In view of the near total elimination of infection from virally suppressed patients to uninfected partners and unborn infants, the HIV community has embraced a treatment-as-prevention strategy aimed at providing early access to HIV testing and treatment to prevent AIDS-related sickness and death while simultaneously preventing HIV transmission.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) has suggested a set of targets known as the "90-90-90 targets," proposing that by 2020, 90% of people living with HIV (PLHIV) should know their HIV serostatus, 90% of diagnosed individuals should be on ART, and 90% of people on ART should achieve sustained viral suppression. The proposition is that attaining the 90-90-90 targets could potentially lead to a 90% reduction in AIDS incidence, AIDS-related deaths, and new HIV infections by 2030 as compared with 2010 levels. Very clearly, the 90-90-90 targets align well with efforts to optimize the HIV care continuum, a concept central to generating demand for and optimally delivering services as well as monitoring and evaluation to hold ourselves accountable for progress made, or a lack thereof, in achieving the therapeutic and preventive benefits of ART.

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Treatment as Prevention®

BC Centre for Excellence in HIV/AIDS

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Optimizing the HIV Care Environment: A Human Rights Imperative

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