PDF(Pubmed)
Abstract：
UNASSIGNED: To prioritize and tailor interventions for ending AIDS by 2030 in Africa, it is important to characterize the population groups in which HIV viraemia is concentrating.
UNASSIGNED: We analysed HIV testing and viral load data collected between 2013-2019 from the open, population-based Rakai Community Cohort Study (RCCS) in Uganda, to estimate HIV seroprevalence and population viral suppression over time by gender, one-year age bands and residence in inland and fishing communities. All estimates were standardized to the underlying source population using census data. We then assessed 95-95-95 targets in their ability to identify the populations in which viraemia concentrates.
UNASSIGNED: Following the implementation of Universal Test and Treat, the proportion of individuals with viraemia decreased from 4.9% (4.6%-5.3%) in 2013 to 1.9% (1.7%-2.2%) in 2019 in inland communities and from 19.1% (18.0%-20.4%) in 2013 to 4.7% (4.0%-5.5%) in 2019 in fishing communities. Viraemia did not concentrate in the age and gender groups furthest from achieving 95-95-95 targets. Instead, in both inland and fishing communities, women aged 25-29 and men aged 30-34 were the 5-year age groups that contributed most to population-level viraemia in 2019, despite these groups being close to or had already achieved 95-95-95 targets.
UNASSIGNED: The 95-95-95 targets provide a useful benchmark for monitoring progress towards HIV epidemic control, but do not contextualize underlying population structures and so may direct interventions towards groups that represent a marginal fraction of the population with viraemia.
UNASSIGNED: We analysed HIV testing and viral load data collected between 2013-2019 from the open, population-based Rakai Community Cohort Study (RCCS) in Uganda, to estimate HIV seroprevalence and population viral suppression over time by gender, one-year age bands and residence in inland and fishing communities. All estimates were standardized to the underlying source population using census data. We then assessed 95-95-95 targets in their ability to identify the populations in which viraemia concentrates.
UNASSIGNED: Following the implementation of Universal Test and Treat, the proportion of individuals with viraemia decreased from 4.9% (4.6%-5.3%) in 2013 to 1.9% (1.7%-2.2%) in 2019 in inland communities and from 19.1% (18.0%-20.4%) in 2013 to 4.7% (4.0%-5.5%) in 2019 in fishing communities. Viraemia did not concentrate in the age and gender groups furthest from achieving 95-95-95 targets. Instead, in both inland and fishing communities, women aged 25-29 and men aged 30-34 were the 5-year age groups that contributed most to population-level viraemia in 2019, despite these groups being close to or had already achieved 95-95-95 targets.
UNASSIGNED: The 95-95-95 targets provide a useful benchmark for monitoring progress towards HIV epidemic control, but do not contextualize underlying population structures and so may direct interventions towards groups that represent a marginal fraction of the population with viraemia.
摘要：
■优先考虑和调整干预措施，以在非洲到2030年结束艾滋病，表征HIV病毒血症集中的人群群体是很重要的.
■我们分析了2013年至2019年之间公开收集的HIV检测和病毒载量数据，乌干达基于人口的Rakai社区队列研究（RCCS），按性别估计HIV血清阳性率和人群病毒抑制，一岁的乐队和居住在内陆和渔业社区。使用人口普查数据将所有估计值标准化为基础来源人群。然后，我们评估了95-95-95个目标识别病毒血症集中人群的能力。
■在实现通用测试和治疗之后，在内陆社区,病毒血症患者的比例从2013年的4.9%(4.6%-5.3%)降至2019年的1.9%(1.7%-2.2%),在渔业社区,从2013年的19.1%(18.0%-20.4%)降至2019年的4.7%(4.0%-5.5%).病毒血症并未集中在距离达到95-95-95目标最远的年龄和性别组中。相反，在内陆和渔业社区，年龄在25~29岁的女性和年龄在30~34岁的男性是2019年造成人口水平病毒血症的主要5岁年龄组,尽管这些年龄组接近或已经达到了95~95~95的指标.
■95-95目标为监测艾滋病毒流行控制进展提供了有用的基准，但不要将潜在的人口结构与背景联系起来，因此可以将干预措施引导到代表病毒血症人口中边缘部分的群体。
■我们分析了2013年至2019年之间公开收集的HIV检测和病毒载量数据，乌干达基于人口的Rakai社区队列研究（RCCS），按性别估计HIV血清阳性率和人群病毒抑制，一岁的乐队和居住在内陆和渔业社区。使用人口普查数据将所有估计值标准化为基础来源人群。然后，我们评估了95-95-95个目标识别病毒血症集中人群的能力。
■在实现通用测试和治疗之后，在内陆社区,病毒血症患者的比例从2013年的4.9%(4.6%-5.3%)降至2019年的1.9%(1.7%-2.2%),在渔业社区,从2013年的19.1%(18.0%-20.4%)降至2019年的4.7%(4.0%-5.5%).病毒血症并未集中在距离达到95-95-95目标最远的年龄和性别组中。相反，在内陆和渔业社区，年龄在25~29岁的女性和年龄在30~34岁的男性是2019年造成人口水平病毒血症的主要5岁年龄组,尽管这些年龄组接近或已经达到了95~95~95的指标.
■95-95目标为监测艾滋病毒流行控制进展提供了有用的基准，但不要将潜在的人口结构与背景联系起来，因此可以将干预措施引导到代表病毒血症人口中边缘部分的群体。
