Background

In 2017, an estimated 36.9 million people were living with HIV, of whom an estimated 1.8 million people (including 160,000 children) acquired their infection within the year, and 940,000 people had died from AIDS-related illnesses. There has been significant progress over the past decade in the global health response to HIV/AIDS. Since 2010, the annual number of new HIV infections has declined by 16%. Due to widespread ART coverage, AIDS-related deaths have fallen by 51% since 2004 [1]. 

We have entered the age of epidemic control, and the end of the HIV pandemic is coming within reach. The World Health Organization (WHO) and the President’s Emergency Plan for AIDS Relief (PEPFAR) have set global goals that call for 95% of all people living with HIV (PLHIV) to be diagnosed, 95% of these to be initiated and retained on antiretroviral therapy (ART), and 95% of these to be virally suppressed (95-95-95). As countries move closer to reaching “95-95-95,” real-time monitoring of recent HIV infections will allow targeting of the public health response.

Recent population-based health impact assessment (PHIA) data indicate that many countries face large testing gaps, particularly among key and priority populations at elevated risk for acquiring HIV infection [2]. As such, achieving 95% PLHIV diagnosis will require laser-focused prevention interventions and integrated HIV testing models that can identify new infections rapidly and effectively interrupt transmission patterns across all age bands, genders, and risk groups. 

To attain this level of efficiency and to maximize case finding, programs need high-quality, real-time data in order to target the right interventions to the right population at the right time. Focusing on new infected HIV+ individuals, recency data can be compiled and analyzed in real-time. Furthermore, the rapid test for recent infection can be deployed at HIV testing sites (HTS) as an addition to the existing national algorithms. 

  1. UNAIDS, Ending the AIDS Epidemic 2030 – Global Statistics. UNAIDS Fact Sheet, 2018.
  2. Population-Based HIV Impact Assessment 2015-2018 Summary Sheets: Preliminary Findings. https://phia.icap.columbia.edu/. Accessed February 8, 2019.