The Revolving Door of HIV Care: Revising the Service Delivery Cascade To Achieve the UNAIDS 95-95-95 Goals

Since 2014, the global public health community has recognized a set of targets for human immunodeficiency virus (HIV) known as “90-90-90,” an ambitious plan that called for the diagnosis of 90% of people living with HIV (PLHIV), antiretroviral therapy(ART) for 90% of those diagnosed HIV–positive, and viral suppression in 90% of those receiving ART by 2020. In an effort to end HIV as a global health threat, these initial goals were extended to achieve “95-95-95” by 2030. Despite tremendous progress toward achieving these objectives, challenges remain. At the end of 2019, an estimated 81% of PLHIV globally knew their HIV status, 82% of these were on ART, and 88% of people on ART were virally suppressed, suggesting an overall viral suppression proportion of just 59%.

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