An improved HIV care cascade to assess HIV control programs among people who inject drugs

Background Achievement of HIV control among key populations through universal access to antiretroviral treatment (ART) requires a precise evaluation of the cascade of care. One of the main difficulties in obtaining an accurate community-based cascade of care is misreporting, which could represent one of the most important bias for people suffering from stigma. The primary objective was to estimate the added value of plasma antiretroviral concentration to improve the estimation of HIV cascade of careMethods We constructed the cascade of HIV care among persons who inject drugs (PWID) living in Hai Phong, Vietnam, using a community-based survey. First and second line HIV treatment contained fixed dose of lamivudine. Misreporting of HIV status and ART were identified by plasma lamivudine detection. We then compared the two methods for estimating the cascade of HIV careResults The proportion of misreporting was estimated at 30% among PWID. No specific PWID profile could be identified as associated with misreporting.Conclusions Adding plasma ARV detection to the routine data collection strongly improved the accuracy of the HIV cascade of care.