Results from an HIV survey of unprecedented scope, led by ICAP at Columbia University Mailman School of Public Health, has spurred optimism throughout Ethiopia, the latest country to announce data from the fourteen-country Population-based HIV Impact Assessment (PHIA) Project. The PHIA survey in Ethiopia, or EPHIA, is the first to estimate HIV incidence, viral load suppression (VLS), and pediatric prevalence in urban Ethiopia.
EPHIA surveyed 10,529 households in urban areas, covering 20,170 people between the ages of 15–64 years. The survey evaluated urban areas because previous studies showed very low HIV prevalence among populations in rural areas. Data collection officially kicked off on October 4, 2017, and ended on April 25, 2018.
The nationwide effort to collect these critical data was led by the Ethiopian Public Health institute and Federal Ministry of Health. When announcing results at a press conference on December 10, officials renewed their commitment to expand access to HIV testing and link people living with HIV to care.
The release of EPHIA results marks the 11th country participating in the PHIA Project to announce results in the past two years. Three additional countries—Haiti, Kenya, and Rwanda—will release PHIA Project data during 2019, which will be invaluable in charting progress and addressing gaps as the global health community pursues a vision of epidemic control by 2030. Summary sheets, first reports, and final reports of PHIA surveys are available on the project website.
“The EPHIA survey’s partnerships made it possible to collect data that have the potential to inform decisions and save lives,” said Dr. Jessica Justman, MD, PHIA Project principal investigator, senior technical director at ICAP, and Columbia Mailman School associate professor of Epidemiology. “ICAP was proud to partner with Ethiopia Public Health Institute and Federal Ministry of Health to conduct EPHIA, and we are grateful to the thousands of participants who contributed to our better understanding of Ethiopia’s HIV epidemic.”
Ethiopia has made considerable progress toward the UNAIDS 90-90-90 targets; namely, that 90 percent of all people living with HIV will know their HIV status, 90 percent of those diagnosed with HIV infection will receive sustained combination antiretroviral therapy (ART), and 90 percent of all people receiving ART will be virally suppressed by 2020. The findings indicate that 72 percent of HIV-positive people aged 15–64 in urban Ethiopia were aware of their HIV status, 99 percent of those aware of their HIV-positive status reported current use of ART, and 90 percent of those reporting current use of ART were virally suppressed.
“EPHIA results show that thousands of Ethiopians in urban areas are receiving the treatment they need to keep the HIV virus in check and live healthy lives,” said Zenebe Melaku, MD, country director for ICAP in Ethiopia. “We are encouraged by this progress and the efforts Ethiopia is making to identify and treat all people infected with HIV.”
With guidance from PHIA results, each surveyed country is revising policies and programs to improve access to HIV testing, help people diagnosed with HIV to have access and adhere to treatment regimens, and provide resources to those individuals whose treatment has not resulted in viral load suppression.
ICAP’s 15-year history of meaningful partnership in the countries hardest hit by the HIV epidemic provides the foundation for its successful implementation of the PHIA surveys. Working with all levels of the health care system, from national leadership to local health facilities and community health workers, ICAP has built trusted relationships and a reputation for excellence that literally open doors. When people receive a knock on their door from PHIA survey staff, they know they are contributing to the health and wellbeing of their entire country.
Among the organizations represented at a press conference in Addis Ababa, Ethiopia to announce the findings, were the U.S. Centers for Disease Control and Prevention (CDC) and ICAP, which works in partnership with CDC on the PHIA Project with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).