HIV cascade of care in Greece: Useful insights from additional stages
Ημερομηνία
2018Συγγραφέας
Nikolopoulos, GeorgiosVourli, Georgia
Paparizos, Vasilios
Skoutelis, Athanasios
Metallidis, Symeon
Gargalianos, Panagiotis
Papadopoulos, Antonios
Chini, Maria
Sipsas, Nikolaos V.
Psychogiou, Mina
Chrysos, Georgios
Sambatakou, Helen
Gogos, Charalambos
Katsarou, Olga
Paraskeva, Dimitra
Dedes, Nikos
Touloumi, Giota
Group, on behalf of the Greek HIV Prevention
ISSN
1932-6203Source
PLOS ONEVolume
13Issue
11Google Scholar check
Metadata
Εμφάνιση πλήρους εγγραφήςΕπιτομή
Background Aiming to eliminate HIV infection, UNAIDS has set a global “90-90-90” target by 2020. We sought to construct a 6-stages HIV Cascade of Care (CoC) in Greece, overall and by risk group, to assess risk-group and stage-specific progress in achieving the UNAIDS target. Patients and methods Combining data from the HIV/AIDS surveillance system and a population-based HIV cohort study, the CoC included: i) number of people living with HIV (PLHIV) by end of 2013 ii) proportion of PLHIV ever diagnosed iii) proportion of diagnosed linked-to-care iv) proportion of linked-to-care ever initiating antiretroviral therapy (ART) v) proportion of treated who retained-in-care vi) proportion of those retained-in-care who were virally suppressed (≤200 copies/mL) at their last visit (01/07/2012-31/12/2013). Results In 2013, 14147 PLHIV were in Greece. Overall, proportions of each stage in the cascade were: 78.4% diagnosed 86% linked-to-care 78.5% initiated ART 86.4% retained-in-care, and 87.1% virally suppressed. Totally, 42.6% of all PLHIV were virally suppressed. The percentage diagnosed was lower among heterosexual men and women (heterosexuals) than in MSM (men who have sex with men) or PWID (people who inject drugs). Most MSM were linked to care (97.2% of diagnosed) while a substantial proportion of PWID were not (80.8% of diagnosed). Once treated, PWID remained in care in similar proportions to MSM. Unlike PWID, a high proportion of the retained in care MSM and heterosexuals achieved viral suppression. Conclusions At the end of 2013, we identified gaps in the HIV CoC in Greece, which differed across risk groups. Targeted interventions are critical in optimizing early diagnosis and timely linkage. A 6-stage CoC, stratified by risk group, can inform strategic public health planning in improving HIV treatment outcomes.