Male engagement in HIV testing, treatment and prevention in eastern and southern Africa — A framework for actionUNAIDS, 2022
Reaching the Sustainable Development Goal target to end AIDS as a public health threat by 2030 requires focusing on and prioritizing people who are not yet accessing lifesaving HIV services. Women are still disproportionately affected than men by HIV, especially in terms of HIV transmission, but men in Eastern and Southern Africa are less likely to access services. They use HIV testing services less, and are less likely to initiate antiretroviral therapy and to remain engaged in care than their female counterparts. Men who are in antiretroviral therapy programmes are 70% more likely to die than women because of their poor health seeking behaviour. This framework categorizes existing research, knowledge and best practices and outlines the necessary building blocks for planning, implementing, and monitoring improvement in the HIV response among men and boys within a broader gender equality framework. The framework is an evidence-based action road map to guide the development of national strategies; when contextualized to local and national contexts and epidemiological situations, the framework provides a foundation for country-led movements to achieve the globally agreed HIV goals in the Global AIDS Strategy 2021–2026 and work towards achieving gender equality.
PEPFAR recognizes the dynamic and unpredictable nature of the COVID-19 pandemic; ongoing case-by-case and context-specific assessments will be essential to determine when activities should be resumed, modified or even paused again. Some COVID-19 spurred innovations in HIV service delivery were client-centered, effective and resource-efficient; such innovative approaches should be incorporated into routine programming. The evidence on the impact of COVID-19 amongst PLHIV is emerging. Technical guidance is provided here (updated January 2022) for a variety of PEPFAR issues and will be updated routinely as the situation evolves.
The Global AIDS Strategy 2021–2026 is a bold new approach to use an inequalities lens to close the gaps that are preventing progress towards ending AIDS. The Global AIDS Strategy aims to reduce these inequalities that drive the AIDS epidemic and prioritize people who are not yet accessing life-saving HIV services. The Strategy sets out evidence-based priority actions and bold targets to get every country and every community on-track to end AIDS as a public health threat by 2030.
HIV drug resistance (HIVDR) can compromise the effectiveness of antiretroviral therapy (ART) in reducing HIV incidence and HIV-associated morbidity and mortality. Minimizing the spread of HIVDR is a critical aspect of the broader global response to antimicrobial resistance. WHO recommends that countries routinely implement nationally representative HIVDR surveys. The WHO HIV drug resistance report 2021 shows substantial progress in the implementation of HIVDR surveillance. Between 2014 and 2021, 56 countries implemented HIVDR surveys using WHO-recommended methods. The HIV drug resistance report 2021 summarizes findings from 38 countries that had finalized the surveys by the time of this report and shared data with WHO. Pretreatment HIVDR to non-nucleoside reverse-transcriptase inhibitors (NNRTI) can affect more than 10% of adults starting therapy and is found up to 3 times more often in people who had previous exposure to antiretroviral drugs. In addition, nearly half of infants newly diagnosed with HIV has HIVDR to NNRTI before initiating treatment.The high levels of observed NNRTI pretreatment HIVDR among emphasize the need to fast-track the transition to WHO-recommended dolutegravir-based ART. Among adults failing NNRTI-based first-line ART, the levels of resistance to these drugs ranged from 50% to 97%. The high levels of HIVDR among individuals with treatment failure, emphasize the need to scale up viral load testing and enhanced adherence counselling and promptly switch individuals with treatment failure.
Each year, the WHO Global TB Report provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease, at global, regional and country levels. This is done in the context of global TB commitments, strategies and targets. The 2021 edition of the report has been produced in a new and more web-centric format. This is designed to make the content available in smaller (more “bite-sized”) chunks that are easier to read, digest, navigate and use. There is a short and slim report PDF with 30 pages of main content plus six short annexes. This is accompanied by expanded and more detailed digital content on web pages.
Over the past 19 years, PEPFAR has had remarkable lifesaving results. PEPFAR has supported antiretroviral treatment for 18.96 million people. PEPFAR has enabled 2.8 million babies to be born HIV-free to mothers living with HIV. The program has provided critical care and support for 7.1 million orphans, vulnerable children, and their caregivers so they can survive and thrive. PEPFAR has helped prevent HIV infection in men and boys, including by supporting nearly 27.7 million voluntary medical male circumcisions in east and Southern Africa. This December 2021 fact sheet provides the latest global program results.
This publication provides managers with guidance on how to create basic HIV prevention cascades as a starting point to enhance their ability to monitor and improve their programming and to facilitate comparisons of programme effectiveness across sites.
The 90–90–90 targets were missed, but not by much. At the end of 2020, 84% of people living with HIV knew their HIV status, 87% of people living with HIV who knew their HIV status were accessing antiretroviral therapy, and 90% of people on treatment were virally suppressed. This UNAIDS report outlines global data - achievements and gaps in 2021.
Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virusWorld Health Organization (WHO), 2021
Validation of elimination of mother-to-child transmission, or vertical transmission, of HIV, syphilis and hepatitis B virus (HBV), is an attestation that a country has successfully met standard criteria for elimination, or for being at 1 of the 3 levels of achievement on the ‘Path to Elimination’ while delivering quality services for women, girls and their children, through the life-course, respecting human rights and ensuring gender equality and community engagement. This document, the third version, adds on EMTCT of hepatitis B virus (HBV), bringing together a package of interventions and metrics to support integrated management and monitoring of vertical transmission across a wide range of epidemiological and programmatic contexts. Establishment of criteria for validation began in 2007 with global consultations while lessons learnt advised publication of 2 editions of global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV and syphilis (the ‘Orange Book’).
Humanity is threatened by an expanding list of pandemics. AIDS is colliding with COVID-19 to deadly effect because much of the world remains dangerously under-prepared and under-resourced to confront the pandemics of today and tomorrow. Over four decades, advances in science, human rights and public health investment have driven remarkable success against AIDS for some locations and populations. This progress has shown what is possible when countries and communities work together against a deadly contagion. Considerable gaps remain. Entrenched inequalities stand in the way of further progress against AIDS and leave the world vulnerable to future pandemics. The colossal new challenges created by COVID-19 threaten the gains made thus far. UNAIDS data show that the curves of HIV infections and AIDS-related deaths are not bending fast enough to end the pandemic. A failure to build on the gains made thus far would result in 7.7 million AIDS-related deaths during this decade. Most of those deaths can be avoided if the world follows the Global AIDS Strategy 2021–2026 and achieves the 2025 targets agreed by the UN General Assembly.