Monitoring progress towards the first UNAIDS 90-90-90 target in key populations living with HIV in Norway

Autor: Kelsey K. Case, Øivind Nilsen, Susan Cowan, Hilde Kløvstad, Robert Whittaker, Ard van Sighem, Hans Blystad
Rok vydání: 2020
Předmět:
Male
0301 basic medicine
Human immunodeficiency virus (HIV)
medicine.disease_cause
Proxy (climate)
Men who have sex with men
Drug Users
Sexual and Gender Minorities
0302 clinical medicine
1108 Medical Microbiology
Prevalence
Medicine
030212 general & internal medicine
Transients and Migrants
education.field_of_study
Norway
Incidence
Statistical models
AIDS
Infectious Diseases
Epidemiological Monitoring
language
Female
0605 Microbiology
Research Article
030106 microbiology
Population
Norwegian
Microbiology
lcsh:Infectious and parasitic diseases
Danish
03 medical and health sciences
Acquired immunodeficiency syndrome (AIDS)
Impact model
Humans
lcsh:RC109-216
Homosexuality
Male
Heterosexuality
education
Africa South of the Sahara
Acquired Immunodeficiency Syndrome
Models
Statistical
business.industry
HIV
1103 Clinical Sciences
medicine.disease
language.human_language
CD4 Lymphocyte Count
business
Delivery of Health Care
Forecasting
Demography
Zdroj: BMC Infectious Diseases
BMC Infectious Diseases, Vol 20, Iss 1, Pp 1-11 (2020)
ISSN: 1471-2334
DOI: 10.1186/s12879-020-05178-1
Popis: Background In line with the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target, Norway aims for at least 90% of people living with HIV (PLHIV) to know their HIV-status. We produced current estimates of the number of PLHIV and undiagnosed population in Norway, overall and for six key subpopulations: Norwegian-born men who have sex with men (MSM), migrant MSM, Norwegian-born heterosexuals, migrant Sub-Saharan Africa (SSA)-born heterosexuals, migrant non-SSA-born heterosexuals and people who inject drugs. Methods We used the European Centre for Disease Prevention and Control (ECDC) HIV Modelling Tool on Norwegian HIV surveillance data through 2018 to estimate incidence, time from infection to diagnosis, PLHIV, and the number and proportion undiagnosed. As surveillance data on CD4 count at diagnosis were not collected in Norway, we ran two models; using default model CD4 assumptions, or a proxy for CD4 distribution based on Danish national surveillance data. We also generated alternative overall PLHIV estimates using the Spectrum AIDS Impact Model, to compare with those obtained from the ECDC tool. Results Estimates of the overall number of PLHIV in 2018 using different modelling approaches aligned at approximately 5000. In both ECDC models, the overall number undiagnosed decreased continuously from 2008. The proportion undiagnosed in 2018 was lower using default model CD4 assumptions (7.1% [95%CI: 5.3–8.9%]), than the Danish CD4 proxy (10.2% [8.3–12.1%]). This difference was driven by results for heterosexual migrants. Estimates for Norwegian-born MSM, migrant MSM and Norwegian-born heterosexuals were similar in both models. In these three subpopulations, incidence in 2018 was Conclusions Results allow cautious confidence in concluding that Norway has achieved the first UNAIDS 90–90-90 target, and clearly highlight the success of prevention strategies among MSM. Estimates for subpopulations strongly influenced by migration remain less clear, and future modelling should appropriately account for all-cause mortality and out-migration, and adjust for time of in-migration.
Databáze: OpenAIRE
Externí odkaz: