番茄社区

AMSTERDAM – Namibia appears to be the first country in Africa to achieve the UNAIDS goal of having at least 73% of HIV-infected people to have viral loads suppressed to less than 1,000 copies/mL, researchers reported here.

In fact, Bernard Haufiku, minister of health and social services of the nation of 2.6 million people, said that 77.4% of the participants in a nationwide sampling had achieved that level of viral load suppression of HIV.

Speaking at the International AIDS Conference, he said "an AIDS free generation is in our reach."

He reported that, overall:

• 86% of the Namibian population with HIV is aware of their infection status
• 96% of the patients who understand that they are infected with the virus are receiving treatment
• 91% of those under treatment have achieved suppression of the virus, or 77.4% of the overall HIV-positive population

"This means that Namibia is already very close to the UNAIDS '90-90-90' target for 2020 – three years ahead of schedule," Haufiku said at a press conference. "So we are on track to control the HIV epidemic with our HIV treatment and prevention programs. The suppression of the virus is a marker of effective treatment and will help us with prevention because, as we all know, treatment by itself is prevention."

"There continues to be very encouraging progress across the region although challenges lie ahead," said Linda-Gail Bekker, MBChB, president of the International AIDS Society, which sponsors the biennial meeting. "We are looking for signs of hope in the fight against HIV and I think this is a shining example. This is exciting and inspiring news."

The UNAIDS 90-90-90 goal is to have 90% of the HIV infection population identified and be aware of their HIV status; 90% of those individuals in treatment programs; and 90% of those in treatment achieving viral load suppression to "undetectable" levels, defined for this purpose as less than 1,000 copies/mL.

Haufiku said that if one looks at the figures by sex, "Namibian women have already reached these 90-90-90 goals. This is something our whole country can celebrate."

In 2015, Namibia implemented an acceleration plan rapidly scaling up HIV testing and treatment services with the goal of reaching the UNAIDS 90-90-90 targets by 2020. In 2017, Namibia conducted the Namibia Population-based HIV Impact Assessment (NAMPHIA) to estimate HIV viral load suppression and progress toward the 90-90-90 targets.

NAMPHIA was funded by and the CDC. The household survey was conducted in 2017 and involved all 14 regions of Namibia. More than 23,000 participants took part and provided blood samples for home-based HIV testing.

NAMPHIA was a cross-sectional household-based survey; analyses were weighted to account for complex survey design. Eligible adults ages 15-64 who consented were interviewed and offered HIV rapid testing according to national guidelines. All HIV-seropositive samples were tested for viral load at a central laboratory.

Haufiku said that the survey results also showed lower HIV incidence. Directly measured incidence was 50% lower than 5 years earlier. In the study he reported an incidence rate of 12.6% – a rate of 15.7% among girls and women and 9.3% among men and boys.

At its worst, the incidence rate of HIV in Namibia hovered around 40% in 1990s, Haufiku told 番茄社区. "We had some areas such as in the northern panhandle, where the borders of four neighbors meet, that had rates as high as 60%," he said. "This was disastrous."

"Taken together, these NAMPHIA results show us where our program has been, but to be most successful we still have some work to do. But I don't see anything standing in the way of us reaching all our objectives," Haufiku said.

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