Progress towards global 95–95–95 targets in Tanzania: trends from population-based HIV impact surveys in 2016–2017 and 2022–2023

Abstract

Background The global 95–95–95 targets aim for 95% of people living with HIV (PLHIV) to know their HIV status, 95% of those diagnosed to receive antiretroviral therapy (ART), and 95% of those on ART to achieve HIV viral load (VL) suppression (VLS). We evaluated Tanzania's progress towards these targets between two HIV surveys. Methods The Tanzania HIV Impact Surveys (THIS) in 2016–2017 and 2022–2023 were independent nationally representative, two stage cluster household surveys. Consenting participants completed a questionnaire and biomarker testing. We reported 95–95–95 achievement among PLHIV aged ≥15 years and the change using prevalence differences. HIV awareness status and ART use were determined through self-report and detection of ARVs in blood while VLS was defined as VL < 1000 copies/mL. Analyses used pooled survey weights and Jackknife variance estimation. Findings This analysis included 1831 PLHIV aged ≥15 years in THIS 2016–2017 and 1850 in THIS 2022–2023. Awareness of HIV-positive status increased from 61.0% [57.1–63.9] in 2017 to 83.0% [80.0–85.1] in 2023, a 22.1% [17.8–26.3] prevalence difference. Among PLHIV aware of their status, ART coverage increased from 93.6% [91.7–95.2] in 2017 to 97.9% [96.7–98.6] in 2023; a 4.2% [2.3–6.2] prevalence difference. Among PLHIV on ART, VLS increased from 87.0% [84.1–89.5] in 2017 to 94.3% [92.6–95.6] in 2023, a 7.2% [4.2–10.3] prevalence difference. Interpretation Tanzania made remarkable progress towards 95–95–95 targets in the five years between surveys. Efforts are needed to enhance case identification through tailored strategies. Funding Funding for this project was supported by the President's Emergency Plan for AIDS Relief through the U.S. Centers for Disease Control and Prevention. The findings and conclusions are those of the authors and do not necessarily represent the official position of the funding agencies.