Reaching the 90-90-90 UNAIDS treatment target for people who inject drugs receiving integrated clinical care at a drug-use outpatient treatment facility

Background People who inject drugs (PWID) experience more gaps at each stage of the HIV care continuum than others living with HIV. The study aimed to describe the effectiveness of an integrated care model to reach the UNAIDS 90-90-90 target. Methods This cross-sectional study included PWID who met the criteria for DSM-5 substance use disorder. They received a multidisciplinary comprehensive program, including medical HIV care, substance use treatment, and psychosocial support, at a drug-use treatment outpatient facility during 2019. The percentage of patients reaching the 90-90-90 UNAIDS target was the main study variable. Results Two hundred and twenty-one PWID were monitored at the facility during a median follow-up of 98 months (IQR: 61-143). Current HIV status was established in all PWID, of whom 84/221 (38.0%) tested HIV-positive. All the 84 patients (100%) received antiretroviral therapy, and 76(90.5%) had RNA HIV-1 < 20 copies/ml during a median of 74 months (IQR: 36-115). The UNAIDS goals were: 84/84 (100%) for the HIV testing, 84/84 (100%) for patients on antiretroviral therapy, and 76/84 (90.5%) for viral suppression. Conclusions Integrated clinical care provided at a drug-use treatment facility is a useful strategy to sustain a long-term HIV care continuum among PWID.