PEPFAR Has Scaled Up HIV ART to About 20 Million Persons Since 2004

Variability seen in viral load coverage and in viral load suppression among distinct subpopulations
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WEDNESDAY, March 15, 2023 (HealthDay News) -- The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has scaled up HIV antiretroviral therapy (ART) to about 20 million persons with HIV infection in 54 countries since 2004, according to research published in the March 14 early-release issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Helen M. Chun, M.D., from the CDC in Atlanta, and colleagues analyzed data from all PEPFAR programs and from six countries that have conducted nationally representative Population-based HIV Impact Assessment surveys, including PEPFAR programmatic data, to examine the use of ART and health system strengthening.

The researchers found that about 20 million persons with HIV infection in 54 countries were receiving PEPFAR-supported ART by September 2022, a 300-fold increase from the 66,550 reported in September 2004. Viral load coverage increased from 24 to 80 percent during 2015 to 2022, and there was an increase in viral load suppression from 80 to 95 percent. Variability in viral load coverage was seen in some subpopulations (children aged younger than 10 years, males, pregnant women, men who have sex with men, persons in prisons, transgender persons) and in viral load suppression in other subpopulations (pregnant and breastfeeding women, persons in prisons, and persons aged younger than 20 years), despite increases in viral load suppression rates and health system strengthening investments.

"To eliminate HIV as a global public health threat, achievements in HIV services must be sustained and expanded to reach all subpopulations," the authors write. "PEPFAR remains committed to supporting partner governments to eliminate HIV as a global public health threat while strengthening public health systems and global health security."

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