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oai:repisalud.isciii.es:20.500.12105/139722025-05-08T15:21:45Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19608

00925njm 22002777a 4500 dc Gourlay, Annabelle author Noori, Teymur author Pharris, Anastasia author Axelsson, Maria author Costagliola, Dominique author Cowan, Susan author Croxford, Sara author d'Arminio Monforte, Antonella author Amo, Julia del author Delpech, Valerie author Diaz Franco, Asuncion author Girardi, Enrico author Gunsenheimer-Bartmeyer, Barbara author Hernando Sebastian, Victoria author Jose, Sophie author Leierer, Gisela author Nikolopoulos, Georgios author Obel, Niels author Op de Coul, Eline author Paraskeva, Dimitra author Reiss, Peter author Sabin, Caroline author Sasse, André author Schmid, Daniela author Sönnerborg, Anders author Spina, Alexander author Suligoi, Barbara author Supervie, Virginie author Touloumi, Giota author Van Beckhoven, Dominique author van Sighem, Ard author Vourli, Georgia author Zangerle, Robert author Porter, Kholoud author European HIV Continuum of Care Working Group author 2017-06-15 Background: The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a "90-90-90" target to curb the human immunodeficiency virus (HIV) epidemic by 2020, but methods used to assess whether countries have reached this target are not standardized, hindering comparisons. Methods: Through a collaboration formed by the European Centre for Disease Prevention and Control (ECDC) with European HIV cohorts and surveillance agencies, we constructed a standardized, 4-stage continuum of HIV care for 11 European Union countries for 2013. Stages were defined as (1) number of people living with HIV in the country by end of 2013; (2) proportion of stage 1 ever diagnosed; (3) proportion of stage 2 that ever initiated ART; and (4) proportion of stage 3 who became virally suppressed (≤200 copies/mL). Case surveillance data were used primarily to derive stages 1 (using back-calculation models) and 2, and cohort data for stages 3 and 4. Results: In 2013, 674500 people in the 11 countries were estimated to be living with HIV, ranging from 5500 to 153400 in each country. Overall HIV prevalence was 0.22% (range, 0.09%-0.36%). Overall proportions of each previous stage were 84% diagnosed, 84% on ART, and 85% virally suppressed (60% of people living with HIV). Two countries achieved ≥90% for all stages, and more than half had reached ≥90% for at least 1 stage. Conclusions: European Union countries are nearing the 90-90-90 target. Reducing the proportion undiagnosed remains the greatest barrier to achieving this target, suggesting that further efforts are needed to improve HIV testing rates. Standardizing methods to derive comparable continuums of care remains a challenge. Clin Infect Dis. 2017 Jun 15;64(12):1644-1656 http://hdl.handle.net/20.500.12105/13972 28369283 10.1093/cid/cix212 1537-6591 Clinical Infectious Diseases: an official publication of the Infectious Diseases Society of America HIV infection Antiretroviral therapy Cohort analysis Continuum of care Surveillance The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges