The UK is one of the first countries to meet the UNAIDS 90-90-90 target. Public Health England’s recent report showed that HIV prevention efforts are working successfully in the UK. London was the first global city to exceed the 95-95-95 target.  They have now been joined by Amsterdam and Melbourne. 2017 statistics reveal [1]:

  • 92% of people living with HIV in the UK have been diagnosed
  • 98% of HIV positive people in the UK were on treatment
  • 97% of HIV positive individuals had an undetectable viral load

The success of the 90-90-90 strategy in the UK is due to a combination of HIV prevention efforts, including an increase in HIV testing and the reduction in time for treatment to begin.

More can be done to end HIV in the UK. Despite the positive results of our current efforts to fight HIV, last year, 43% of new HIV diagnoses were made at a late stage of infection. Public Health England (PHE) continues to stress the importance of HIV testing.

Professor Noel Gill, Head of STI & HIV Department at PHE, said:

“There can be no doubt prevention efforts to end the HIV epidemic in the UK are working. Our efforts must continue apace in order to eliminate HIV. With an estimated 8,000 people still unaware of their infection, it is vital that people seek out an HIV test if they consider themselves at risk, or accept the offer of an HIV test by a healthcare professional, as early diagnosis is key to stopping transmission.” [2]

Whilst the 90-90-90 targets have been emphasised in the UK. Many countries have focussed on increasing people’s access to HIV treatment – the second ‘90’. [3]

Better2Know’s Anthea Morris who spent six months working in a hospital in Tanzania supporting people with HIV said:

“For many people around the world an HIV diagnosis brings with it a huge stigma. Many people in Tanzania were worried about being seen at HIV clinics. So they choose not to attend and not to receive their medication. Reaching out to these people and helping them get HIV treatment is really important to achieving the second and third 90’s.”

Dr Anne Connolly, the clinical lead for sexual health for Bradford district and Craven clinical commissioning groups, warns against complacency:

“It’s really important to remember that HIV hasn’t gone away,

“We would encourage more people to be sure of their status by having a test, particularly if they have changed their partner.

“You can only be certain you have HIV if you have a blood test that looks specifically for the virus.

“The result will let you know if you need to carry on taking precautions to protect yourself against HIV or if you need to start lifesaving treatment and avoid spreading the virus to someone else.” [4]

Anthea Morris continues:

“There is always a reason for not getting tested: you are too busy, you are scared of the result and think you are better off not knowing, or you may think that you are not at risk of catching HIV. Most newly diagnosed people do not think HIV is something that happens to them.  We believe the key is to make getting tested regularly, or at the start of a relationship, a norm. We are working hard to encourage people to change their preconceptions and get tested.”

 

What is the UNAIDS 90-90-90 strategy?

In 2014, the United Nations Joint Programme on HIV and AIDS – UNAIDS – announced the 90-90-90 global strategy. This consisted of three main targets that were to be achieved by 2020:

  • To identify 90% of people living with HIV through expanding testing.
  • To put 90% of HIV positive individuals on antiretroviral therapy.
  • To ensure that 90% of HIV positive people, who are on treatment, have undetectable viral loads.

People are less likely to pass on HIV if these levels of viral suppression are achieved. The 90-90-90 targets are being enforced on a global scale, leading UNAIDS officials to believe that the HIV epidemic could end by 2030. [5]

Anthea Morris said: “It is really important to have ambitious goals to combat HIV. Although the Millenium Development Goal 6 to combat HIV was not fully achieved, huge improvements were made that may not have been with a less ambitious goal.  An end to the HIV epidemic is achievable with everyone working together.”

Michel Sidibe, Executive Director at UNAIDS, said:

“It is four years since we launched 90–90–90 and it has taken us further and faster than we could ever have imagined. With 90–90–90, we have built a bridge that spans the essential elements of the HIV treatment cascade. We must not be scared of the future, we must define it. If we quicken the pace, we can reach 30 million with HIV treatment by 2020.” [6]

 

References

[1] Healthy London: London the first global city to exceed UNAIDS 95-95-95 ambitions

[2] Gov.uk: HIV diagnoses continue to fall as UK exceeds UNAIDS target

[3] World Health Organization: Beyond the 90-90-90: refocusing HIV prevention as part of the global HIV response

[4] Keighly News: Health chiefs ‘get tested’ plea

[5] Verywell Health: Can the UN Strategy to End HIV Epidemic Work?

[6] UNAIDS: Accelerating towards 90-90-90

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