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The HIV care cascade: Japanese perspectives
Aikichi Iwamoto1, Rikizo Taira2, Yoshiyuki Yokomaku3
1Japan Agency for Medical Research and Development, Tokyo, Japan.
Plos One
|March 21, 2017
Summary
Japan has not met key HIV treatment goals, with 14.4% of people living with HIV undiagnosed. While treatment is successful, improved HIV testing and surveillance are needed to reach UNAIDS/WHO targets.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- Japan is considered a low HIV-prevalence country with a concentrated epidemic.
- The achievement of UNAIDS/WHO 90-90-90 goals and the HIV care cascade in Japan remain undetermined.
Purpose of the Study:
- To evaluate whether Japan has met the UNAIDS/WHO 90-90-90 targets.
- To examine the HIV care cascade in Japan.
Main Methods:
- Estimated diagnosed and undiagnosed people living with HIV/AIDS (PLWHA) using legal reports and blood donor data.
- Assessed the HIV care cascade (diagnosis, treatment, viral suppression) via a nationwide questionnaire survey of AIDS Core Hospitals.
Main Results:
- At the end of 2015, an estimated 14.4% of all PLWHA in Japan were undiagnosed.
- Japan achieved 85.6% diagnosis, 82.8% treatment, and 99.1% viral suppression rates among diagnosed individuals.
- The country did not meet the first two UNAIDS/WHO targets (90% diagnosed, 90% treated).
Conclusions:
- Japan's HIV care cascade shows excellent antiretroviral treatment uptake and success.
- Significant unmet needs exist in HIV surveillance and diagnosis, hindering progress towards UNAIDS/WHO targets.
- Promoting HIV testing and treatment, particularly among key affected populations like men who have sex with men, is crucial for reducing the HIV epidemic.
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