Challenges and strategies for ending AIDS after the COVID-19 pandemic

<p>The UNAIDS Global AIDS Strategy 2021-2026 has addressed inequalities in the HIV response, and set new targets of 95-95-95 and less than 370,000 new infections by 2025. Global AIDS Monitoring is the annual worldwide survey that assesses the level of achievement of these goals. According to Global AIDS Monitoring 2022, the number of people living with HIV at the end of 2021 was estimated to be 38.4 million, and 1.5 million persons were newly infected with HIV in 2021. The evidence proved that the pace of the declining trend in HIV incidence had been slowed by the COVID-19 pandemic. The HIV epidemic in Japan has been concentrated among men who have sex with other men, with the number of new HIV infections peaking in 2013, and standing at 1,057 in 2021. However, late diagnoses were reported in 30% or more of infected individuals after developing AIDS, and serious concerns exist regarding a significant decline in the number of HIV tests at public health centers, as this can lead to a larger number of late diagnoses.</p><p>The achievement of the 95-95-95 targets and HIV incidence are estimated in most countries by the software, Spectrum®, which was developed by UNAIDS, and the level of achievement of the triple 95 was 85-88-92 in 2021, globally. While Japan might be achieving the 95-95-95 targets according to the estimates provided by Spectrum®, there are challenges in collecting epidemiological data for the parameters in Spectrum®, such as incidence rates among immigrants.</p><p>The national AIDS prevention guidelines have been updated every 6 years, and the next update is expected to be undertaken in 2024. In order to enhance Japan’s response, the adoption of science-based intervention, such as promoting combination prevention, utilizing digital health, increasing the availability of multiple modes of HIV testing, integrating multiple municipal programs, and facilitating community- and patient-led services should be considered, with the aim of ending AIDS by 2030.</p>