There is an error in Table 1. The sixth row under the “Medical Interventions” heading is missing. Please see the correct Table 1 here.
Table 1. Coverage goals and effects for the interventions included in this analysis.
Intervention | 2020 Coverage | 2030 Coverage | Effects |
---|---|---|---|
KEY POPULATIONS | |||
Service package for female sex workers | 90% | 90% | 90% condom use at last sex act |
Service package for MSM | 90% | 90% | 90% condom use at last sex act |
Service package for transgender populations | 90% | 90% | 90% condom use at last sex act |
Service package for PWID | 90% | 90% | 90% condom use at last sex act, 51% reduction in percentage sharing needles |
Opioid substitution therapy for PWID | 40% | 40% | 46% reduction in number of sexual partners, 71% reduction in needle sharing |
Service package for prisoners | 90% | 90% | Increased condom use in prisons |
BEHAVIOUR CHANGE INTERVENTIONS | |||
Condom promotion | 90% condom use at last sex | 90% condom use at last sex | 90% condom use at last sex among people with multiple partners |
Cash transfers for girls | 30% In Hyper-endemic countries with low rates of secondary school enrollment1 | 50% In Hyper-endemic countries with low rates of secondary school enrollment1 | 40% reduction in incidence among young women and girls (15–24 years old) in areas with low rates of secondary enrollment [6] |
MEDICAL INTERVENTIONS | |||
PMTCT | 95% | 95% | 80% starting ART before current pregnancy, 15% starting during current pregnancy. 98% reduction in perinatal transmission, 87% reduction in transmission during breastfeeding [9] |
Male circumcision | 90% of 10–29 year old men in countries with generalized epidemics and low MC rate2 | 90% of 10–29 year old men in countries with generalized epidemics and low MC rate2 | 60% reduction in susceptibility [10, 11, 12] |
Post-exposure prophylaxis (PEP) | 80% | 80% | Provided to rape victims and health workers experiencing accidental exposure |
PrEP for sero-discordant couples | 10% in generalized and hyper-endemic countries | 30% in generalized and hyper-endemic countries | 80% reduction in susceptibility for sero-discordant couples. PrEP includes oral pills, vaginal gel, vaginal ring and injectable forms. [13, 14, 15, 16] |
PrEP for sex workers, MSM, transgenders and PWID | 10% | 30% | 80% reduction in susceptibility |
PrEP for sexually active females 15–24 in areas with incidence above 3% in this population group | 10% in hyper-endemic countries | 30% in hyper-endemic countries | 80% reduction in susceptibility. For adolescent females we assume half this effect through 2020 then the full effect after 2020. PrEP includes oral pills, vaginal gel, vaginal ring and injectable forms. [13, 14, 15, 16] |
Testing | 24% of all adults and children in countries with generalized epidemics and of key populations and people with multiple partners in countries with concentrated epidemics | Gradual decrease to 20% of key populations, those with multiple partners and pregnant women in all countries with incidence below 0.1%. 20% of adults and children in countries with incidence above 0.1% | Identify HIV+ for linkage to care |
Pre-ART care | 81% of PLHIV not on ART | 90% of PLHIV not on ART | |
Adult ART | 81% (90% started, 90% retained) | 90% (95% started, 95% retained) | Eligibility for treatment expands to all PLHIV by 2018. 95% reduction in infectiousness among those virally suppressed [17]. By 2030 AIDS-specific mortality rates decline by 50% from 2015 rates due to enhanced retention and viral suppression. |
SOCIAL ENABLERS | Includes community mobilization3, media communications4 and other general population approaches that support behavior change |
1 Hyper-endemic countries are: Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe.
2 Countries include Botswana, Ethiopia (Gambela only), Kenya (Nyanza only), Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, South Sudan, Swaziland, United Republic of Tanzania, Uganda, Zambia and Zimbabwe.
3 Community mobilization can be divided into three categories: Outreach and peer communication and engagement activities; support activities; and advocacy, transparency and accountability. Community mobilization can be supported through community system strengthening which is a systematic approach to promote the development of informed, capable and coordinated communities and community based organizations. Hallmarks of effective community system strengthening include the involvement of a broad range of community actors and enabling them to contribute as equal partners alongside other actors to the long term sustainability of health and other interventions at community level. Community system strengthening aims to improve health outcomes by developing the role of key affected populations, communities and community based organizations in the design, delivery, monitoring and evaluation of services, activities and programs.
4 Media communication utilizes one or more channels to transmit a specific message to a large audience. Examples include brochures, billboards, posters, newspaper or magazine articles, comic books, television, radio, music videos, Internet, cell phones, songs, dramas, traditional and folk media, and interactive theatre. Media communication includes development of communication messages and materials and their transmission. Media communication seeks to promote positive changes in cognitive and behavioural outcomes such as increasing knowledge of modes of HIV transmission, increasing perceived risk of contracting HIV, reducing high-risk sexual behaviours such as having multiple partners, increasing positive protective behaviours such as condom use, and increasing the utilization of health care services. Media communication can also be utilized to create a supportive environment and often targets social, cultural and gender norms that may hinder behaviour change.
Reference
- 1.Stover J, Bollinger L, Izazola JA, Loures L, DeLay P, Ghys PD, et al. (2016) What Is Required to End the AIDS Epidemic as a Public Health Threat by 2030? The Cost and Impact of the Fast-Track Approach. PLoS ONE 11(5): e0154893 10.1371/journal.pone.0154893 [DOI] [PMC free article] [PubMed] [Google Scholar]