Statistical Methods for Global Health and Epidemiology by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783030352608
Publisher: Springer International Publishing

8.2 Ending the HIV/AIDS Epidemic by 2030

The epidemic of the human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS) is a typical global health problem (Chen, 2014; Merson, Black, & Mills, 2012). Worldwide, the number of persons living with HIV (PLWH) has totaled 36.9 million (WHO, 2018). The impact of HIV/AIDS on human health is global; therefore, effective HIV/AIDS control and prevention requires collaborative and global efforts (Deeks et al., 2016; International Aids Society Scientific Working Group on H I V Cure et al., 2012). No one individual country is immune to HIV infection and no one individual country alone can get rid of the HIV epidemic without involving other countries and agencies in the world.

In fighting the HIV/AIDS epidemic, two strategies are widely used: (1) Antiretroviral therapy (ART) and (2) prevention intervention programs. The first strategy is designated for treating persons living with HIV (PLWH) whose viral load has not been suppressed and this strategies has been widely implemented across the globe (Tanser, Barnighausen, Grapsa, Zaidi, & Newell, 2013; UNAIDS, 2017a). In addition to treading the infected, appropriate implementation of ART, such as treatment as prevention (TasP) can help PLWH to achieve viral suppression, reducing the number of infected persons who can infect others (Cohen, 2011; Granich et al., 2010).

The second strategy of prevention is for all persons who are at risk for HIV infection, including the PLWH who can be re-infected (Lyles et al., 2007). These programs include school- or community-based interventions for general population and venue-based high-risk population intervention (e.g., drug users, men who have sex with men, sex workers). To develop and implant either an ART program or a prevention intervention strategy, adequate data are always needed for strategic planning, evidence-based decision-making, and objective program evaluation (Courtenay-Quirk, Spindler, Leidich, & Bachanas, 2016; H. I. V. Modelling Consortium Treatment as Prevention Editorial Writing Group, 2012; Marsh & Farrell, 2015).

Based on the epidemic of HIV/AIDS and success in treatment and prevention, the Jointed United Nations Program on HIV/AIDS sets the goal to End the AIDS Epidemic by 2030 (UNAIDS, 2014b). To achieve the goal, the UNAIDS further asked that by 2020, 90% of PLWH know their HIV status, 90% of diagnosed PLWH receive sustained ART and 90% who receive ART have their blood viral load suppressed (90-90-90 strategy) (UNAIDS, 2017a). Pursuing these goals requires collaborative efforts to plan and deliver patient-centered ART and population-centered (both the general and at-risk population) prevention programs to reduce the risk of HIV transmission by all possible venues, including sexual contact, needle sharing and vertical maternal-child transition (AVERT, 2017; CDC, 2018b; National Health and Family Planning Commission of PRC, 2015; WHO, 2017).

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