We reviewed published national HIV care continua for men who have sex with men (MSM), people who inject drugs (PWID), and female sex workers (FSWs) to track progress toward the 90-90-90 target. We searched the Internet, PubMed, surveillance reports, United Nations Programme on HIV/AIDS country reports, US President’s Emergency Plan for AIDS Relief country/regional operational plans, and conference abstracts for the continua and graded them on quality. We found 12 continua for MSM, 7 for PWID, and 5 for FSW from 12 countries. HIV diagnosis, antiretroviral therapy coverage, and viral suppression varied between (1) 5% and 85%, 2% and 73%, and 1% and 72%, respectively for MSM; (2) 54% and 96%, 14% and 80%, and 8% and 68%, respectively for PWID; and (3) 27% and 63%, 8% and 16%, and 2% and 14%, respectively for FSW. Two countries, using data from national cohorts, were high quality. There are limited key population continua in the public domain. Of the few available, none have achieved 90-90-90. Improved monitoring and evaluation of key population continua is necessary to achieve the 90-90-90 target.
CohenMSChenYQMcCauleyM; HPTN 052 Study Team. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.
3.
INSIGHT START Study Group; LundgrenJDBabikerAGGordinF. Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection. N Engl J Med. 2015;373(9):795–807.
4.
TEMPRANO ANRS 12136 Study Group; DanelCMohRGabillardD. A trial of early antiretrovirals and isoniazid preventive therapy in Africa. N Engl J Med. 2015;373(9):808–822.
5.
GranichRMGilksCFDyeCDe CockKMWilliamsBG. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet. 2009;373(9657):48–57.
6.
GardnerEMMcLeesMPSteinerJFDel RioCBurmanWJ. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis. 2011;52(6):793–800.
BaralSBeyrerCMuessigK. Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(7):538–549.
9.
BeyrerCSullivanPSanchezJ. The increase in global HIV epidemics in MSM. AIDS. 2013;27(17):2665–2678.
10.
MathersBMDegenhardtLPhillipsB; 2007 Reference Group to the UN on HIV and Injecting Drug Use. Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. Lancet. 2008;372(9651):1733–1745.
11.
MountainEMishraSVickermanPPicklesMGilksCBoilyMC. Antiretroviral therapy uptake, attrition, adherence and outcomes among HIV-infected female sex workers: a systematic review and meta-analysis. PloS One. 2014;9(9):e105645.
12.
WolfeDCarrieriMPShepardD. Treatment and care for injecting drug users with HIV infection: a review of barriers and ways forward. Lancet. 2010;376(9738):355–366.
US President’s Emergency Plan for AIDS Relief (PEPFAR). FY 2016 PEPFAR Country Operational Plan Strategic Direction Summaries. Washington, DC: PEPFAR; 2016. http://www.pepfar.gov/countries/cop/c71522.htm. Accessed September 4, 2016.
15.
OkanoJTRobbinsDPalkLGerstoftJObelNBlowerS. Testing the hypothesis that treatment can eliminate HIV: a nationwide, population-based study of the Danish HIV epidemic in men who have sex with men. Lancet Infect Dis. 2016;16(7):789–796.
16.
SupervieVMartyLLacombeJMDray-SpiraRCostagliolaD; FHDH-ANRS CO4 Study Group. Looking beyond the cascade of HIV care to end the AIDS epidemic: estimation of the time interval from HIV infection to viral suppression. J Acquir Immune Defic Syndr. 2016;73(3):348–355.
17.
US President’s Emergency Plan for AIDS Relief (PEPFAR). Caribbean Region 2016 Regional Operational Plan Strategic Direction Summary. Washington, DC: PEPFAR; 2016. http://www.pepfar.gov/documents/organization/257656.pdf. Accessed September 4, 2016.
18.
US President’s Emergency Plan for AIDS Relief (PEPFAR). Central Asia Region 2016 Regional Operational Plan Strategic Direction Summary. Washington, DC: PEPFAR; 2016. http://www.pepfar.gov/documents/organization/257618.pdf. Accessed September 4, 2016.
US President’s Emergency Plan for AIDS Relief (PEPFAR). Swaziland 2016 Country Operational Plan Strategic Direction Summary. Washington, DC: PEPFAR; 2016. http://www.pepfar.gov/documents/organization/257630.pdf. Accessed September 4, 2016.
22.
US President’s Emergency Plan for AIDS Relief (PEPFAR). Asia Regional Program 2016 Regional Operational Plan Strategic Direction Summary. Washington, DC: PEPFAR; 2016. http://www.pepfar.gov/documents/organization/257358.pdf. Accessed September 4, 2016.
23.
DelpechV. Health System Concerns Related to TasP and Most At Risk Populations: Example from the United Kingdom. Presented at: Conference on Controlling the HIV Pandemic with Antiretrovirals: Treatment as Prevention and Pre-Exposure Prophylaxis. London, UK, 2012.
24.
Centers for Disease Control and Prevention (CDC). Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data—United States and 6 Dependent Areas—2013. HIV Surveillance Supplemental Report 2015; 20 (No. 2). Atlanta, GA: CDC; 2015. http://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillancereport_vol20_no2.pdf. Accessed September 4, 2016.
25.
International Association of Providers of AIDS Care (IAPAC). Global HIV 90-90-90 Watch. Washington, DC: IAPAC; 2015. http://www.hiv90-90-90watch.org/. Updated October, 2016. Accessed December 18 , 2016.
AltmanDAggletonPWilliamsM. Men who have sex with men: stigma and discrimination. Lancet. 2012;380(9839):439–445.
28.
DeckerMRCragoALChuSK. Human rights violations against sex workers: burden and effect on HIV. Lancet. 2015;385(9963):186–199.
29.
KamarulzamanAAlticeFL. Challenges in managing HIV in people who use drugs. Curr Opin Infect Dis. 2015;28(1):10–16.
30.
World Health Organization (WHO). Guideline on When to Start Antiretroviral Therapy and on Pre-Exposure Prophylaxis for HIV. Geneva, Switzerland: WHO; 2015. http://www.who.int/hiv/pub/guidelines/earlyrelease-arv/en/. Accessed September 4, 2016.
31.
International Association of Providers of AIDS Care (IAPAC). Global HIV Policy Watch. Washington, DC: IAPAC; 2015. http://www.hivpolicywatch.org/. Updated October, 2016. Accessed December 18, 2016.
32.
HladikWBenechIBateganyaMHakimAJ. The utility of population-based surveys to describe the continuum of HIV services for key and general populations. Int J STD AIDS. 2016;27(1):5–12.
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