Towards achieving the fast-track targets and ending the epidemic of HIV/AIDS in Ethiopia: Successes and challenges

Yibeltal Assefa; Charles F Gilks; Judith Dean; Betru Tekle; Meskele Lera; Taye Tolera Balcha; Yimam Getaneh; Wim Van Damme; Peter S Hill

doi:10.1016/j.ijid.2018.10.022

Towards achieving the fast-track targets and ending the epidemic of HIV/AIDS in Ethiopia: Successes and challenges

Int J Infect Dis. 2019 Jan:78:57-64. doi: 10.1016/j.ijid.2018.10.022. Epub 2018 Nov 1.

Authors

Yibeltal Assefa¹, Charles F Gilks², Judith Dean², Betru Tekle³, Meskele Lera⁴, Taye Tolera Balcha⁵, Yimam Getaneh⁶, Wim Van Damme⁷, Peter S Hill²

Affiliations

¹ School of Public Health, the University of Queensland, Brisbane, Australia. Electronic address: y.alemu@uq.edu.au.
² School of Public Health, the University of Queensland, Brisbane, Australia.
³ United Nations Programme on HIV/AIDS, Kigali, Rwanda.
⁴ Federal Ministry of Health, Addis Ababa, Ethiopia.
⁵ Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
⁶ Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
⁷ Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.

PMID: 30391417
DOI: 10.1016/j.ijid.2018.10.022

Abstract

Background: Ethiopia has adopted the global plan to end the epidemic of HIV/AIDS. The aim of this study was to assess the progress made towards achieving this plan.

Methods: A review and analysis of national population-based surveys, surveillance, and routine programme data was executed. The data analysis was conducted using Excel 2016 and Stata 14 (StataCorp LP, College Station, TX, USA).

Results: Between 2011 and 2016, the number of HIV-related deaths dropped by 58%, while that of new HIV infections dropped by only 6%. Discriminatory attitudes declined significantly from 77.9% (95% confidence interval (CI) 77.3-78.4%) in 2011 to 41.5% (95% CI 40.6-42.4%) in 2016. Around 79% of adult people living with HIV (PLHIV) were aware of their HIV status; 90% of PLHIV who were aware of their HIV status were taking antiretroviral treatment (ART) and 88% of adult PLHIV on ART had viral suppression in 2016. The proportion of people aged 15-49 years who had ever been tested for HIV and had received results increased from 39.8% (95% CI 39.2-40.4%) in 2011 to 44.8% (95% CI 44.2-45.4%) in 2016. This proportion was very low among children below age 15 years at only 6.2% (95% CI 5.9-6.5%). Among regions, HIV testing coverage varied from 13% to 72%. Female sex workers had lower coverage for HIV testing (31%) and ART (70%) than the national average in the adult population. International funding for HIV dropped from more than US$ 1.3 billion in 2010-2012 to less than US$ 800 million in 2016-2018.

Conclusions: Ethiopia is on track to achieve the targets for HIV testing, ART, viral suppression, and AIDS-related deaths, but not for reductions in new HIV infections, discriminatory attitudes, and equity. Ending the epidemic of HIV/AIDS requires a combined response, including prevention and treatment, tailored to key populations and locations, as well as increased funding.

Keywords: Ending the epidemic; Ethiopia; Fast-track targets; HIV/AIDS; Prevention; Treatment.

MeSH terms

Adolescent
Adult
Anti-Retroviral Agents / therapeutic use
Epidemics*
Ethiopia / epidemiology
Female
HIV Infections / diagnosis
HIV Infections / drug therapy
HIV Infections / epidemiology*
Humans
Male
Mass Screening
Middle Aged
Prevalence
Retrospective Studies
Young Adult

Substances

Anti-Retroviral Agents