Progress towards 90-90-90 and 95-95-95 strategy implementations and HIV positivity trends in the City of Johannesburg.

Background: The 95-95-95 strategy implementation is a positive initiative for moving the HIV tide towards elimination, with a focus on addressing the huge inequalities in existence in access to HIV services.

Objectives: To establish performance towards the 90-90-90 and 95-95-95 targets and trends in HIV positivity rates since strategy implementation rollout in the City of Johannesburg (CoJ), South Africa.

Methods: This was a descriptive study, part of the bigger quasi-experimental study using the monthly District Health Information System during the implementation and rollout of the 90-90-90 strategy. HIV access trends were tracked and compared with the set strategy implementation targets. In addition, the HIV positivity rate was analysed to observe trends. A time trend analysis for aggregated data was performed on all the measured indicators to determine whether the decrease or increase was statistically significant. P<0.05 was used to indicate statistical significance.

Results: The study has shown that by March 2022, 15 months after December 2020, CoJ had reached 91-65-88. There were significant steady increases in the number of people who knew their HIV status (slope = 0.044, p<0.001) and initiating on antiretroviral therapy (ART) (slope = 0.001, p<0.001), and significant decreases for overall HIV positivity rate (slope = -0.016, p<0.001), adolescent positivity rate (slope = -0.0087, p<0.001) and antenatal care HIV positivity rate (slope = -0.013, p<0.001).

Conclusion: This study has established positive progress made by the CoJ towards HIV testing, ART initiation, viral load suppression and HIV positivity rate. On the other hand, gaps in linkage to care after testing positive have been highlighted. It is therefore critical in the 95-95-95 strategy implementation era to focus on finding those missed during the 90-90-90 phase through revised and renewed innovative approaches.