Sweden is the first country to achieve the Joint United Nations Programme on HIV/AIDS (UNAIDS)/World Health Organization (WHO) 90-90-90 continuum of HIV care target, according to a study published in HIV Medicine.1
Using HIV surveillance data reported to the Public Health Agency of Sweden, the researchers noted that diagnosis, linkage to care, retention of care, administration of antiretroviral therapy (ART), and a suppressed viral load were well beyond the 90% goal established by UNAIDS/WHO.
Several factors probably made the results favorable, especially the fact that Sweden is a low-endemic country with < 8000 people estimated to have HIV. Linkage to care and retention of care were 99.8% and 97.1% respectively, since the InfCare HIV database facilitates high-quality care and treatment. ART is prescribed free of charge and adherence is high.
On December 31, 2015, “6605 of 6946 patients (95.1%) were on ART. A total of 6395 had been on treatment for at least 6 months and 6503 of those (94.7%) had a viral load < 50 copies/mL.” Many other studies use 200 copies/mL as the target viral suppression, the researchers purposely used 50 copies/mL as the cut-off to highlight the reliability of the data.
The researchers noted that while it is difficult to estimate how many individuals are unaware of being infected with HIV, even with using older models of 15% who may unaware, “the coverage target of 73% would have been met.”