HIV epidemic in the Maghreb. Magnitude, trend and management

Abstract

Over the last two decades, many progress has transformed the profile of HIV infection and improved the survival and quality of life of people living with HIV (PLHIV). In addition to individual benefits, antiretrovirals allow through viral suppression to prevent HIV transmission. The dual benefit, curative and preventive, of antiretrovirals has propel HIV testing at the forefront of the global Fast Track strategy as principle access to care and prevention. In the Maghreb countries, these achievements are impeded by a number of barriers that limit access for PLHIV, especially key populations and vulnerable populations, to appropriate care and prevention services. In order to achieve the global goals of Fast Track strategy, policy makers need to implement high-impact interventions to facilitate access to HIV testing, improve referral to care, strengthen adherence and retention to care. This can be achieved through mobile and community-based testing to target key populations, and innovative approaches such as partner notification and HIV self-testing. The establishment of robust links to care centers ensures rapid initiation of antiretrovirals in order to achieve viral suppression. Morever, these goals can be achieved by removing barriers to access to HIV testing and care. This is include specific interventions based on the respect of human rights, the fight against stigma and discrimination, the review of legislation limiting the legal age for access to voluntary testing and the removal of punitive laws against key populations.