Human immunodeficiency virus continuum of care in 11 european union countries at the end of 2016 overall and by key population: Have we made progress?

Georgia Vourli; Teymur Noori; Anastasia Pharris; Kholoud Porter; Maria Axelsson; Josip Begovac; Francoise Cazein; Dominique Costagliola; Susan Cowan; Sara Croxford; Antonella d.Arminio Monforte; Valerie Delpech; Asunción Díaz; Enrico Girardi; Barbara Gunsenheimer-Bartmeyer; Victoria Hernando; Gisela Leierer; Florence Lot; Olivier Nunez; Niels Obel; Eline Op de Coul; Dimitra Paraskeva; Stavros Patrinos; Peter Reiss; Daniela Schmid; Anders Sonnerborg; Barbara Suligoi; Virginie Supervie; Ard van Sighem; Robert Zangerle; Giota Touloumi; Alexander Egle; Manfred Kanatschnig; Angela Öllinger; Armin Rieger; Brigitte Schmied; Elmar Wallner; Diyani Dewasurendra; Martin Gisinger; Maria Kitchen; Alexander Plattner; Elisabeth Rieser; Mario Sarcletti; Richard Greil; Michaela Schachner; Matthias Skocic; Monika Müller; Regina Aichwalder; David Chromy; Katharina Grabmeier-Pfstershammer; European HIV Continuum of Care Working Group; Selwyn Lowe; Astrid Oude Lashof; Dirk Posthouwer; Robin Ackens; Katinka Burgers; Jolanda Schippers; Inge van Loo; Thomas Havenith

doi:10.1093/cid/ciaa696

Human immunodeficiency virus continuum of care in 11 european union countries at the end of 2016 overall and by key population: Have we made progress?

Georgia Vourli^*, Teymur Noori, Anastasia Pharris, Kholoud Porter, Maria Axelsson, Josip Begovac, Francoise Cazein, Dominique Costagliola, Susan Cowan, Sara Croxford, Antonella d.Arminio Monforte, Valerie Delpech, Asunción Díaz, Enrico Girardi, Barbara Gunsenheimer-Bartmeyer, Victoria Hernando, Gisela Leierer, Florence Lot, Olivier Nunez, Niels ObelEline Op de Coul, Dimitra Paraskeva, Stavros Patrinos, Peter Reiss, Daniela Schmid, Anders Sonnerborg, Barbara Suligoi, Virginie Supervie, Ard van Sighem, Robert Zangerle, Giota Touloumi, Alexander Egle, Manfred Kanatschnig, Angela Öllinger, Armin Rieger, Brigitte Schmied, Elmar Wallner, Diyani Dewasurendra, Martin Gisinger, Maria Kitchen, Alexander Plattner, Elisabeth Rieser, Mario Sarcletti, Richard Greil, Michaela Schachner, Matthias Skocic, Monika Müller, Regina Aichwalder, David Chromy, Katharina Grabmeier-Pfstershammer, European HIV Continuum of Care Working Group, Selwyn Lowe, Astrid Oude Lashof, Dirk Posthouwer, Robin Ackens, Katinka Burgers, Jolanda Schippers, Inge van Loo, Thomas Havenith

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background. High uptake of antiretroviral treatment (ART) is essential to reduce human immunodeficiency virus (HIV) transmission and related mortality; however, gaps in care exist. We aimed to construct the continuum of HIV care (CoC) in 2016 in 11 European Union (EU) countries, overall and by key population and sex. To estimate progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target, we compared 2016 to 2013 estimates for the same countries, representing 73% of the population in the region. Methods. A CoC with the following 4 stages was constructed: number of people living with HIV (PLHIV); proportion of PLHIV diagnosed; proportion of those diagnosed who ever initiated ART; and proportion of those ever treated who achieved viral suppression at their last visit. Results. We estimated that 87% of PLHIV were diagnosed; 92% of those diagnosed had ever initiated ART; and 91% of those ever on ART, or 73% of all PLHIV, were virally suppressed. Corresponding figures for men having sex with men were: 86%, 93%, 93%, 74%; for people who inject drugs: 94%, 88%, 85%, 70%; and for heterosexuals: 86%, 92%, 91%, 72%. The proportion suppressed of all PLHIV ranged from 59% to 86% across countries. Conclusions. The EU is close to the 90-90-90 target and achieved the UNAIDS target of 73% of all PLHIV virally suppressed, significant progress since 2013 when 60% of all PLHIV were virally suppressed. Strengthening of testing programs and treatment support, along with prevention interventions, are needed to achieve HIV epidemic control.

Original language	English
Pages (from-to)	2905-2916
Number of pages	12
Journal	Clinical Infectious Diseases
Volume	71
Issue number	11
DOIs	https://doi.org/10.1093/cid/ciaa696
Publication status	Published - 1 Dec 2020

Keywords

Continuum of care
Europe
HIV infection
Key population
Sex

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Vourli, G., Noori, T., Pharris, A., Porter, K., Axelsson, M., Begovac, J., Cazein, F., Costagliola, D., Cowan, S., Croxford, S., Monforte, A. D. A., Delpech, V., Díaz, A., Girardi, E., Gunsenheimer-Bartmeyer, B., Hernando, V., Leierer, G., Lot, F., Nunez, O., ... Havenith, T. (2020). Human immunodeficiency virus continuum of care in 11 european union countries at the end of 2016 overall and by key population: Have we made progress? Clinical Infectious Diseases, 71(11), 2905-2916. https://doi.org/10.1093/cid/ciaa696

@article{95aadda2d2fd4b218d1b1a7f75c63a93,

title = "Human immunodeficiency virus continuum of care in 11 european union countries at the end of 2016 overall and by key population: Have we made progress?",

abstract = "Background. High uptake of antiretroviral treatment (ART) is essential to reduce human immunodeficiency virus (HIV) transmission and related mortality; however, gaps in care exist. We aimed to construct the continuum of HIV care (CoC) in 2016 in 11 European Union (EU) countries, overall and by key population and sex. To estimate progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target, we compared 2016 to 2013 estimates for the same countries, representing 73% of the population in the region. Methods. A CoC with the following 4 stages was constructed: number of people living with HIV (PLHIV); proportion of PLHIV diagnosed; proportion of those diagnosed who ever initiated ART; and proportion of those ever treated who achieved viral suppression at their last visit. Results. We estimated that 87% of PLHIV were diagnosed; 92% of those diagnosed had ever initiated ART; and 91% of those ever on ART, or 73% of all PLHIV, were virally suppressed. Corresponding figures for men having sex with men were: 86%, 93%, 93%, 74%; for people who inject drugs: 94%, 88%, 85%, 70%; and for heterosexuals: 86%, 92%, 91%, 72%. The proportion suppressed of all PLHIV ranged from 59% to 86% across countries. Conclusions. The EU is close to the 90-90-90 target and achieved the UNAIDS target of 73% of all PLHIV virally suppressed, significant progress since 2013 when 60% of all PLHIV were virally suppressed. Strengthening of testing programs and treatment support, along with prevention interventions, are needed to achieve HIV epidemic control.",

keywords = "Continuum of care, Europe, HIV infection, Key population, Sex",

author = "Georgia Vourli and Teymur Noori and Anastasia Pharris and Kholoud Porter and Maria Axelsson and Josip Begovac and Francoise Cazein and Dominique Costagliola and Susan Cowan and Sara Croxford and Monforte, {Antonella d.Arminio} and Valerie Delpech and Asunci{\'o}n D{\'i}az and Enrico Girardi and Barbara Gunsenheimer-Bartmeyer and Victoria Hernando and Gisela Leierer and Florence Lot and Olivier Nunez and Niels Obel and {Op de Coul}, Eline and Dimitra Paraskeva and Stavros Patrinos and Peter Reiss and Daniela Schmid and Anders Sonnerborg and Barbara Suligoi and Virginie Supervie and {van Sighem}, Ard and Robert Zangerle and Giota Touloumi and Alexander Egle and Manfred Kanatschnig and Angela {\"O}llinger and Armin Rieger and Brigitte Schmied and Elmar Wallner and Diyani Dewasurendra and Martin Gisinger and Maria Kitchen and Alexander Plattner and Elisabeth Rieser and Mario Sarcletti and Richard Greil and Michaela Schachner and Matthias Skocic and Monika M{\"u}ller and Regina Aichwalder and David Chromy and Katharina Grabmeier-Pfstershammer and {European HIV Continuum of Care Working Group} and Selwyn Lowe and {Oude Lashof}, Astrid and Dirk Posthouwer and Robin Ackens and Katinka Burgers and Jolanda Schippers and {van Loo}, Inge and Thomas Havenith",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2020.",

year = "2020",

month = dec,

day = "1",

doi = "10.1093/cid/ciaa696",

language = "English",

volume = "71",

pages = "2905--2916",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

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Vourli, G, Noori, T, Pharris, A, Porter, K, Axelsson, M, Begovac, J, Cazein, F, Costagliola, D, Cowan, S, Croxford, S, Monforte, ADA, Delpech, V, Díaz, A, Girardi, E, Gunsenheimer-Bartmeyer, B, Hernando, V, Leierer, G, Lot, F, Nunez, O, Obel, N, Op de Coul, E, Paraskeva, D, Patrinos, S, Reiss, P, Schmid, D, Sonnerborg, A, Suligoi, B, Supervie, V, van Sighem, A, Zangerle, R, Touloumi, G, Egle, A, Kanatschnig, M, Öllinger, A, Rieger, A, Schmied, B, Wallner, E, Dewasurendra, D, Gisinger, M, Kitchen, M, Plattner, A, Rieser, E, Sarcletti, M, Greil, R, Schachner, M, Skocic, M, Müller, M, Aichwalder, R, Chromy, D, Grabmeier-Pfstershammer, K, European HIV Continuum of Care Working Group, Lowe, S , Oude Lashof, A , Posthouwer, D, Ackens, R, Burgers, K, Schippers, J, van Loo, I & Havenith, T 2020, 'Human immunodeficiency virus continuum of care in 11 european union countries at the end of 2016 overall and by key population: Have we made progress?', Clinical Infectious Diseases, vol. 71, no. 11, pp. 2905-2916. https://doi.org/10.1093/cid/ciaa696

TY - JOUR

T1 - Human immunodeficiency virus continuum of care in 11 european union countries at the end of 2016 overall and by key population

T2 - Have we made progress?

AU - Vourli, Georgia

AU - Noori, Teymur

AU - Pharris, Anastasia

AU - Porter, Kholoud

AU - Axelsson, Maria

AU - Begovac, Josip

AU - Cazein, Francoise

AU - Costagliola, Dominique

AU - Cowan, Susan

AU - Croxford, Sara

AU - Monforte, Antonella d.Arminio

AU - Delpech, Valerie

AU - Díaz, Asunción

AU - Girardi, Enrico

AU - Gunsenheimer-Bartmeyer, Barbara

AU - Hernando, Victoria

AU - Leierer, Gisela

AU - Lot, Florence

AU - Nunez, Olivier

AU - Obel, Niels

AU - Op de Coul, Eline

AU - Paraskeva, Dimitra

AU - Patrinos, Stavros

AU - Reiss, Peter

AU - Schmid, Daniela

AU - Sonnerborg, Anders

AU - Suligoi, Barbara

AU - Supervie, Virginie

AU - van Sighem, Ard

AU - Zangerle, Robert

AU - Touloumi, Giota

AU - Egle, Alexander

AU - Kanatschnig, Manfred

AU - Öllinger, Angela

AU - Rieger, Armin

AU - Schmied, Brigitte

AU - Wallner, Elmar

AU - Dewasurendra, Diyani

AU - Gisinger, Martin

AU - Kitchen, Maria

AU - Plattner, Alexander

AU - Rieser, Elisabeth

AU - Sarcletti, Mario

AU - Greil, Richard

AU - Schachner, Michaela

AU - Skocic, Matthias

AU - Müller, Monika

AU - Aichwalder, Regina

AU - Chromy, David

AU - Grabmeier-Pfstershammer, Katharina

AU - European HIV Continuum of Care Working Group

AU - Lowe, Selwyn

AU - Oude Lashof, Astrid

AU - Posthouwer, Dirk

AU - Ackens, Robin

AU - Burgers, Katinka

AU - Schippers, Jolanda

AU - van Loo, Inge

AU - Havenith, Thomas

PY - 2020/12/1

Y1 - 2020/12/1

N2 - Background. High uptake of antiretroviral treatment (ART) is essential to reduce human immunodeficiency virus (HIV) transmission and related mortality; however, gaps in care exist. We aimed to construct the continuum of HIV care (CoC) in 2016 in 11 European Union (EU) countries, overall and by key population and sex. To estimate progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target, we compared 2016 to 2013 estimates for the same countries, representing 73% of the population in the region. Methods. A CoC with the following 4 stages was constructed: number of people living with HIV (PLHIV); proportion of PLHIV diagnosed; proportion of those diagnosed who ever initiated ART; and proportion of those ever treated who achieved viral suppression at their last visit. Results. We estimated that 87% of PLHIV were diagnosed; 92% of those diagnosed had ever initiated ART; and 91% of those ever on ART, or 73% of all PLHIV, were virally suppressed. Corresponding figures for men having sex with men were: 86%, 93%, 93%, 74%; for people who inject drugs: 94%, 88%, 85%, 70%; and for heterosexuals: 86%, 92%, 91%, 72%. The proportion suppressed of all PLHIV ranged from 59% to 86% across countries. Conclusions. The EU is close to the 90-90-90 target and achieved the UNAIDS target of 73% of all PLHIV virally suppressed, significant progress since 2013 when 60% of all PLHIV were virally suppressed. Strengthening of testing programs and treatment support, along with prevention interventions, are needed to achieve HIV epidemic control.

AB - Background. High uptake of antiretroviral treatment (ART) is essential to reduce human immunodeficiency virus (HIV) transmission and related mortality; however, gaps in care exist. We aimed to construct the continuum of HIV care (CoC) in 2016 in 11 European Union (EU) countries, overall and by key population and sex. To estimate progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target, we compared 2016 to 2013 estimates for the same countries, representing 73% of the population in the region. Methods. A CoC with the following 4 stages was constructed: number of people living with HIV (PLHIV); proportion of PLHIV diagnosed; proportion of those diagnosed who ever initiated ART; and proportion of those ever treated who achieved viral suppression at their last visit. Results. We estimated that 87% of PLHIV were diagnosed; 92% of those diagnosed had ever initiated ART; and 91% of those ever on ART, or 73% of all PLHIV, were virally suppressed. Corresponding figures for men having sex with men were: 86%, 93%, 93%, 74%; for people who inject drugs: 94%, 88%, 85%, 70%; and for heterosexuals: 86%, 92%, 91%, 72%. The proportion suppressed of all PLHIV ranged from 59% to 86% across countries. Conclusions. The EU is close to the 90-90-90 target and achieved the UNAIDS target of 73% of all PLHIV virally suppressed, significant progress since 2013 when 60% of all PLHIV were virally suppressed. Strengthening of testing programs and treatment support, along with prevention interventions, are needed to achieve HIV epidemic control.

KW - Continuum of care

KW - Europe

KW - HIV infection

KW - Key population

KW - Sex

U2 - 10.1093/cid/ciaa696

DO - 10.1093/cid/ciaa696

M3 - Article

SN - 1058-4838

VL - 71

SP - 2905

EP - 2916

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 11

ER -

Human immunodeficiency virus continuum of care in 11 european union countries at the end of 2016 overall and by key population: Have we made progress?

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Keywords

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