Achieving the fast track 90-90-90 and 95-95-95 targets in sub-Saharan Africa: A rapid review

Abstract

Background: The Joint United Nations Programme on HIV/AIDS (UNAIDS) set targets for 95% of people living with human immunodeficiency virus (HIV) infection to know their status, 95% to receive antiretroviral therapy (ART) and 95% to achieve viral suppression. These targets mirror the 90-90-90 targets that were aimed to be met by 2020 to end AIDS as a public health threat by 2030.

Aim: The study aims to synthesise evidence on recommendations, best practices and challenges in achieving 90-90-90 escalated to 95-95-95 fast-track targets in sub-Saharan Africa.

Setting: The review included empirical evidence from sub-Saharan Africa.

Method: We followed Arksey and O’Malley’s methodological framework for this scoping review. A systematic search of relevant articles was conducted using electronic databases such as Scopus, EBSCOHost, PubMed, Science Direct and Sabinet. The results were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.

Results: There were 6943 relevant study titles that were identified from the five databases. Following duplicates removal, title and abstract screening, 31 articles were included for full-text review. A combination of qualitative, quantitative and mixed methods studies were included.

Conclusion: The 90-90-90 targets have been achieved in part, but challenges remain, particularly for key and vulnerable populations. Even as successes and challenges towards ‘90-90-90 by 2020’ are outlined, new fast-track ‘95-95-95 by 2030’ targets have been established because of concerns that the original targets may not have achieved epidemic control.

Contribution: The findings of this review have implications for policy and practice related to interventions to facilitate the realisation of HIV epidemic control as outlined by the UNAIDS 95-95-95 treatment cascade.