A group of researchers have argued that the Joint United Nations Programme on HIV/AIDS’s (UNAIDS) plan to beat the HIV pandemic through what is known as treatment as prevention (TasP) is not feasible because of the difficulty in reaching the large numbers of those living in remote areas of sub-Saharan Africa, Medical Xpress reports.
In 2014, UNAIDS called on nations to get 90 percent of their respective HIV populations diagnosed, 90 percent of that group on antiretrovirals (ARVs) and 90 percent of that group virally suppressed by 2020. This would mean that 73 percent of a nation’s HIV population would have an undetectable viral load, which research has found is associated with an extremely low, possibly nonexistent, risk of transmitting the virus to others.
UNAIDS predicts that accomplishing the 90-90-90 feat, would put nations on the road to considerable reductions in rates of new HIV infections, eventually eliminating the virus as a major public health threat.
Publishing their findings in Science Translational Medicine, researchers in this new study used statistical mapping methods to estimate where all HIV-positive people in Lesotho live. Approximately one quarter of the adult population of this sub-Saharan African nation is living with the virus.
The study authors found that the UNAIDS approach to getting HIV diagnosis, treatment and viral suppression rates to very high levels represents a steep challenge in Lesotho because the HIV population in the nation is widely dispersed: Only about 30 percent live in urban areas. It would be a considerable challenge to locate and provide HIV testing to all these individuals and keep them in regular effective medical care. A considerable number of the nation’s HIV-positive inhabitants reside in areas where there are only two or fewer people with HIV per square kilometer.
The researchers devised a different strategy that made use of patterns of settlement, population density and the spatial arrangement of the nation’s HIV population to most effectively allocate resources to combat the epidemic.
To read the study abstract, click here.
To read the Medical Xpress article, click here.