The continuum of HIV care enables countries to monitor the success of their HIV response, from diagnosis to viral suppression.
A new report by the European Center for Disease Prevention and Control (ECDC) released key findings regarding the continuum of HIV care in Europe, using data from countries in Europe and Central Asia.
The continuum of HIV care enables countries to monitor the success of their HIV response, from diagnosis to viral suppression. The new report summarizes the status of the continuum of care for the whole region and the 38 countries that reported at least some data.
Since the findings of the 2015 ECDC Dublin Declaration report on the HIV care continuum, the ECDC now monitors a 4-stage continuum directly relevant to the European region. Stage 1 is the estimated number of all people living with HIV (PLHIV). Stage 2 is the number of all PLHIV who have been diagnosed. Stage 3 is the number of PLHIV who have been diagnosed and who are on antiretroviral therapy (ART), and stage 4 is the number of PLHIV on ART who are virally suppressed.
The report revealed that the proportion of all countries able to report on all 4 stages of the continuum dramatically increased from 40% in 2014 to 66% in 2016. For the 37 countries reporting data within Europe and Central Asia for both stage 1 and stage 2, there were an estimated 1,199,000 PLHIV, of whom 75% have been diagnosed. This equates to nearly 1 of 4 people with diagnosed HIV who are still not on treatment.
In the 31 countries reporting data from both stage 3 and stage 4 in Europe and Central Asia, 599,500 PLHIV are on treatment and 88% are virally suppressed. Although there have been clear improvements, stage 1 and 4 remains the stages where countries are least likely to have available data.
The ECDC is helping to address this issue by supporting the countries in Europe and Central Asia in the use of their HIV modeling tool to help produce robust estimates of the number of PLHIV. Additionally, they are encouraging collaboration between public health and clinical experts to boost viral suppression estimates.
The report concludes that European and Central Asian countries need to improve the availability of continuum data, as well as use the continuum of HIV care framework to monitor progress and zero in on areas that need improvement.
Furthermore, these areas should capture country-specific measures to strengthen testing, treatment, and care to further progress towards the UNAIDS 90-90-90 targets.