New data released by the Government of Rwanda, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the U.S. Centers for Disease Control and Prevention (CDC), and ICAP at Columbia University, has indicated that Rwanda made record in achieving HIV epidemic control — particularly in attaining high levels of linkage to treatment and viral load suppression among people living with HIV.
The data, which was released yesterday, indicates that 76 per cent of all HIV-positive adults, including almost 80 percent of HIV-positive women, have achieved viral load suppression, a widely used measure of effective HIV treatment in a population.
This, the report says, has made Rwanda reach or exceed the UNAIDS 90–90–90 target sex external icon, particularly among women, and nationally by attaining 84–98–90 among adults.
The UNAIDS’ 90-90-90 is a plan aimed at completely uprooting HIV. By 2020, 90% of all people living with HIV are expected to be knowing their HIV status. By the same year, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy, while 90% of all people receiving antiretroviral therapy will have viral suppression.
The preliminary survey findings of the report reflect the degree to which Rwanda’s national HIV programs and policies have contributed significantly towards reducing new infections and ensuring people living with HIV are linked to and sustained on HIV treatment.
According to the report, the Rwanda Population HIV Impact Assessment (RPHIA) results will also inform the future direction of Rwanda’s efforts to reach epidemic control by closing identified gaps.
“RPHIA preliminary findings highlight the results of strong leadership and partnership that characterized the fight against HIV in Rwanda in the wake of the genocide against the Tutsis that affected our country,” Dr Diane Gashumba, Health Minister said in reaction to the released data.
“I am happy with our progress towards achieving 90-90-90 UNAIDS global targets. The remaining gaps identified will require more efforts and continued partnerships – I commend the great support from PEPFAR, CDC, ICAP and other research institutions in Rwanda involved in the design, implementation and analysis of these data. We look forward to disseminating the RPHIA results in Kigali, Rwanda, on 22 October 2019,” she added.
Ambassador Deborah L. Birx, U.S. Global AIDS Coordinator and U.S. Representative for Global Health Diplomacy, congratulated Rwanda on the unmatched milestone achieved.
“We congratulate Rwanda on these remarkable results. They prove what’s possible through the combination of political leadership, proactive policies, data-driven programs, and community engagement—all essential ingredients for reaching HIV/AIDS epidemic control,”
“Congratulations to the government and people of Rwanda for their dedication to stopping their HIV epidemic and linking more than 97 per cent of those diagnosed into care,” he said.
According to CDC Director Robert Redfield, “The success they (Rwanda) have achieved in surpassing the UNAIDS 2020 goal demonstrates the power of effective HIV treatment and care. CDC remains committed to supporting Rwanda and other nations as they respond to the HIV pandemic and save lives.”
From October 2018-March 2019, RPHIA reached over 11,000 households across the country, surveying more than 30,000 adults aged 15-64 years, and over 9,000 young adolescents aged 10-14 years. The survey provided home-based HIV testing and counselling services, with the return of results and linkage to care for those who tested HIV-positive.
The key results released yesterday include information on the percentage of people living with HIV (prevalence), the number of new HIV infections occurring each year (incidence), and the percentage of people with low levels of virus in their blood (viral load suppression), described by age, sex, and geographic variation.
According to the survey, HIV prevalence among adults, aged 15-64 years, was 3.0% between 2018-2019, indicating that approximately 210,200 adults in Rwanda were living with HIV. HIV prevalence was higher in women (3.7%) than men (2.2%).
The survey adds that HIV prevalence was 1.9 times higher in urban areas compared to rural areas, while the annual incidence of HIV among adults was 0.08%, corresponding to approximately 5,400 new cases of HIV per year in Rwanda.
Among all adults living with HIV, says the survey, 76% had suppressed viral loads – 79.1% among women and 70.5% among men.
In relation to UNAIDS 90-90-90 targets, when combining self-reported and laboratory data, results of the survey indicated that 8% of adults living with HIV were aware of their status, based on self-reporting or the detection of antiretrovirals (ARVs) in participants’ blood samples.
Furthermore, of adults who knew their status, 97.5% were on ART, based on self-reporting or the detection of ARVs, while among adults who had detectable ARVs or reported current use of ARVs, 90.1% had Viral Load Suppression.