Treatment Growth, Continuity of Treatment, and Viral Load Suppression
USAID's investments in treatment growth, continuity of treatment, and viral load suppression support comprehensive life-saving antiretroviral therapy (ART) programs around the globe to ensure those who need it have access to treatment and can achieve optimal health outcomes and a high quality of life.
Since USAID’s first investments over 35 years ago in fighting HIV, there has been significant progress that has impacted the lives of millions of people living with HIV and their families. From cutting-edge therapeutics to innovative service delivery models to data analytics and strengthening health systems, USAID has been at the forefront to support comprehensive life-saving antiretroviral therapy (ART) programs around the globe to ensure those who need it have access to lifesaving treatment and can achieve optimal health outcomes and high quality of life.
ART stops the replication of the HIV virus inside a person infected with HIV, allowing the body’s immune system time to recover and rebuild itself. While not curative, these medicines are powerful, with studies suggesting that people living with HIV (PLHIV) can achieve similar life expectancies as people without HIV, provided they are diagnosed quickly, have good access to medical care, and are able to adhere to HIV treatment. In addition, by lowering the amount of HIV virus in the body, antiretroviral drugs (ARVs) help reduce the chance that an HIV-positive individual transmits the infection to an HIV-negative partner. In 2022, 39 million people were living with HIV worldwide. USAID supports more than seven million people with life-saving HIV treatment. Ninety-six percent of these beneficiaries who received a viral load test are virally suppressed, meaning that these people living with HIV can live longer, healthier lives, and that they will not transmit the virus to others.
In spite of the many challenges posed by the HIV epidemic, global access to ART has increased substantially since 2003, with 29.8 million people accessing ART in 2022. Access to these lifesaving treatments has reduced the number of AIDS-related deaths by 69 percent since the peak in 2004 and new HIV infections have been reduced by 38 percent since 2010. Globally, 19.1 million people are supported by U.S. Government assistance under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The U.S. Government is the world’s largest donor to HIV and AIDS programs worldwide, having invested over $100 billion through PEPFAR in the HIV response, with much of that support managed by USAID.
Our Approach and Results
USAID-supported treatment programs ensure all newly diagnosed individuals are placed on robust optimized HIV treatment regimens and are supported to stay on lifelong treatment in order to achieve viral load suppression. Successful treatment and achieving viral load suppression also prevents transmission and continued progress towards epidemic control. Ensuring all clients have access to continuous, uninterrupted ART requires programs that are tailored to meet their needs and preferences. USAID does this through the implementation of best practices and interventions to reduce barriers to HIV treatment and support services, including those who are the most vulnerable, such as children and adolescents living with HIV, pregnant and breastfeeding women and their infants, and other key populations.
USAID-supported ART programs focus on three key priorities to ensure lifelong continuity of treatment to ultimately achieve viral load suppression (VLS) and optimal health outcomes for all clients:
Improving access to optimized ART for all PLHIV to achieve viral load suppression.
Improving the quality of ART services to ensure clients can easily engage in treatment services and have access to lifelong continuous ART.
Fostering the sustainability of lifelong HIV treatment services to ensure a robust and resilient health system that can maintain high-quality services and effectively respond to challenges and other new or emerging health threats.
To accomplish these priorities, USAID and its implementing partners have utilized a variety of innovative programmatic approaches. They include:
Implementing client-centered interventions such as multi-month dispensing and decentralized drug delivery to increase flexibility and reduce the burden on clients in order to access treatment more easily.
Using technologies like mobile phones and automated drug pick up points, to help support client adherence to medication and health care.
Pooling procurement and using generic antiretroviral medicines to lower the price of HIV medicines ten-fold in order to accelerate access to the most effective and robust HIV treatment regimens in resource-limited settings.
Task sharing and creative deployment of health care workers to ensure clients can receive the highest quality services they need wherever they prefer to use those services.
Developing robust information systems for clinical settings and for the management of commodities to improve the quality of care provided to clients.
USAID's efforts in treatment growth, continuity of treatment, and viral load suppression have led to achievements in the following areas:
Provided HIV treatment services and WHO-recommended optimized HIV treatment regimens to 6.7 million people living with HIV across 21 countries and three regional programs in 2023.
Initiated over 750,000 newly diagnosed people on lifesaving ART.
Supported 27 countries to reach over 95 percent viral load suppression.
Resources
Banner photo: A mom and her baby meet with a nurse at Mangochi district hospital in Malawi. /Credit: Thoko Chikondi for USAID.