Applying New Methods to Estimate Viral Suppression: The “Last 90”


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Author(s): Zadrozny, S., Weir, S., Edwards, J., & Herce, M.

Year: 2018


Zadrozny, S., Weir, S., Edwards, J., & Herce, M. (2018). Applying new methods to estimate viral suppression: The “last 90.” Chapel Hill, NC, USA: MEASURE Evaluation, University of North Carolina.
Applying New Methods to Estimate Viral Suppression: The “Last 90” Abstract:

The goal of HIV prevention, care, and treatment programs is to maximize the time that people living with HIV spend alive, well, and with a suppressed viral load.

The purpose of these guidelines is to describe an operational protocol for applying new methods to estimate viral suppression—the “last 90” of the 90-90-90 cascade1—at the clinical, programmatic, regional, or national level. These approaches can be used for any population living with HIV and can be tailored to focus on population subgroups or key populations (KPs).

The last 90 is an “ambitious treatment target to help end the AIDS epidemic,” according to the Joint United Nations Programme on HIV/AIDS (UNAIDS) (UNAIDS, 2017). The United States Agency for International Development (USAID), through the United States President’s Emergency Plan for AIDS Relief (PEPFAR), is working to achieve the 90–90–90 global goals by 2020.

USAID reports that more than 36.7 million people are living with HIV worldwide (USAID, 2018). Its Office of HIV/AIDS provides global leadership to respond to the epidemic and supports country efforts to meet the challenge. MEASURE Evaluation, funded by USAID and PEPFAR, works across the globe to strengthen health information systems, conduct research and evaluation, and develop global guidance and tools to improve the response to the epidemic in low-resource settings. The project works with USAID and countries to ensure cost-effective, sustainable, and integrated HIV and AIDS programming, using evidence-informed approaches and innovations.

Tools such as the Viral Load Calculator described in this document are among the solutions the project supports to improve data, so as to better describe the epidemic in any locale. In this way, enhanced strategies can be developed to achieve local and global goals. MEASURE Evaluation’s activities take a holistic view of health information systems and the complex contexts that attend HIV and AIDS issues, underpinned by our own research and applications of best practices to advance the field.

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