Progress toward the second and third UNAIDS 95-95-95 targets among adolescents and young adults in the Ekurhuleni district, South Africa

We investigated the progress towards the second and third 95-95-95 UNAIDS targets among adolescents and young adults (AYA) living with HIV in the Ekurhuleni district, South Africa. A total of 39,038 AYA were tested for HIV in 2018, 17.0% (95% CI: 16.6%-17.4%) tested positive, 79.5% (95% CI: 78.5%-80.5%) were aged 20-24, and the majority were females 86.8% (95% CI: 86.0%-87.6%) and of these females 33.8% (95% CI: 32.6%-35.1%) were pregnant. Antiretroviral therapy (ART) initiation rate was 81.9% (95% CI: 81.0%-82.9%) and 63% were initiated on the same day. Viral load suppression had an upward trajectory of 63%, 66%, 71%, 73%, 81%, while retention rate regressed from 67%, 63%, 62%, 60%, 56% over 12, 24, 36, 48 and 60 months. Compared to males, females achieved greater proportions while when comparing the three-age bands, AYA aged 20-24 achieved better outcomes than AYA aged 10-14 and 15-19. These findings underscore the importance of interventions focused on targeted testing and diagnosis, linkage to treatment, retention to care and viral load suppression of younger adolescents (10-14 years) and male AYA and implementation of age and gender disaggregated HIV cascade indicators tracking for this subpopulation.