90-90-90 Program

Tens of millions of people "live with HIV" all over the world, and tens of thousands of people "live with HIV" in Iran. The existence of this disease is undeniable and after years of denial, the world finally came to the conclusion that something should be done instead of denying the reality. For this reason, the World Health Organization introduced the 90-90-90 program.

(Alice O'Connor - writer and philosopher)
Photo source: aynrand

The 90-90-90 program includes 3 indicators and in this program, efforts are made to increase these indicators to above 90%. As always, the first indicator is awareness, and efforts are being made to ensure that 90% of people living with HIV are aware of their condition.

The second goal: 90% of people who know about their HIV condition will be treated with antiretroviral drugs.

And the third goal: 90% of the people who are treated with antiretroviral drugs have suppressed the virus (have responded appropriately to the treatment and the level of HIV virus in their blood is so low that it is undetectable).

And interestingly, in most countries, among these three indicators, the lowest indicator is the first one (awareness) and the most efforts should be made in that field (performing the HIV test).

There are tens of thousands iranian living with HIV

The HIV virus probably entered Iran in 1364 and it doesn't really matter if it was through contaminated blood or another way. It doesn't really matter that in the beginning it was mostly transmitted through contaminated syringes and now mostly through sex. These issues really do not matter. :-)

The only important thing is that we try and encourage more people to take the HIV test. The more tests are done, the more likely it is to find "people who have recently tested positive" and especially early. Because if a person knows about his HIV status as soon as possible and starts treatment as soon as possible, it will prevent the transmission to others, and he will regain his health sooner, and finally AIDS will be prevented.

Tens of thousands of Iranians are now living with HIV. This disease is not far from us anymore and one person for every 2,000 Iranians lives with HIV. HIV is no longer taboo and should be scientifically treated and eradicated.

1. First 90: 90% of people living with HIV know their status

Definition: the percent of individuals who tested HIV positive and reported that they knew their HIV status (numerator) divided by all individuals who tested HIV positive (denominator).

This is the first goal of the 90-90-90 program and, of course, the most difficult goal. Because in most countries, this index (the number of those who know about their HIV status divided by the total number of people living with HIV) is the lowest index among the three indicators of 90-90-90.

In order to raise this index, we should take more and more HIV tests.

2. Second 90: 90% of prople who know their HIV-positive status are on antiretroviral therapy

Definition: the percent of people who have used antiretroviral drugs (numerator) divided by the total number of people who are aware of their HIV status (the numerator of the previous 90% index is the denominator of this index).

This is the second indicator of the 90-90-90 program. We need to convince as many people living with HIV as possible to cooperate and be treated for free. Treatment has two great aspects for them:
1- Normal lifespan
2- Non-transmission of HIV to those around them: in other words, a person who is being treated with antiretroviral drugs does not have the HIV virus in his/her blood, and as a result, he/she cannot transmit the virus to another person through sex or re-used needles.

3. Third 90: 90% of people on antiretroviral therapy are virally suppressed

Definition: the percent of those who had viral loads of less than 1000 copies per ml (numerator) divided by all people on antiretroviral therapy (the numerator of the previous 90% index is the denominator of this index).

The third indicator of the 90-90-90 program is related to the response rate to treatment. This index shows a person's loyalty to treatment and regular use of medicines. This index in most provinces and countries is usually better than the previous two indices and we don't have much problem with it.

Suppression of the virus is what we are looking for in the whole 90-90-90 program. It means that the viruses in the person's blood are reduced so much that they become undetectable. In this case, he/she will remain in perfect health, he/she will have a normal lifespan, and the probability of transmitting the virus through injection, sex, and mother to fetus is almost zero.

As you can see in the picture, at each stage of the 90-90-90 program, we have a drop in the number of people, and finally, a large number of people living with HIV does not reach the stage of "virus suppression" and "adequate response to treatment".

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