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Trends in population HIV viral suppression: a longitudinal analysis.
Margot Otto1,2, Elphas Okango3, Paul Mee1,4
1Centre for Epidemic Response and Innovation, School for Data Science and Computational Thinking.
AIDS (London, England)
|May 29, 2025
Summary
HIV viral suppression improved in rural KwaZulu-Natal, but recent declines and lower rates than regional estimates highlight the need for targeted interventions, especially for young men.
Area of Science:
- Public Health
- Epidemiology
- HIV/AIDS Research
Background:
- HIV remains a significant public health challenge in rural KwaZulu-Natal (KZN).
- Understanding trends in viral suppression is crucial for effective HIV/AIDS management.
- Previous estimates may not fully capture the nuances of population-level suppression in this specific cohort.
Purpose of the Study:
- To analyze trends in HIV viral suppression from 2011 to 2023 in a rural KZN cohort.
- To investigate the influence of age and sex on HIV viral suppression rates.
- To compare local suppression rates with regional estimates and UNAIDS targets.
Main Methods:
- Retrospective analysis of a rural KZN population-based HIV cohort data (2011-2023).
- Assessment of viral suppression trends over time.
- Stratification of suppression rates by age and sex.
Main Results:
- Overall population viral suppression showed improvement, reaching 71% for men and 79% for women in 2022.
- A notable decline in viral suppression was observed in 2023, potentially linked to COVID-19 disruptions.
- Suppression rates in the cohort were consistently lower than reported regional KZN estimates.
- Significant disparities were identified among younger males, indicating lower suppression rates.
Conclusions:
- While progress in HIV viral suppression has been made, recent setbacks necessitate urgent attention.
- Lower-than-expected suppression rates and age/sex disparities underscore the need for tailored public health interventions.
- Achieving UNAIDS 95-95-95 targets requires focused strategies to address identified gaps, particularly for vulnerable male populations.
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