# Helping Botswana Achieve UNAIDS Treatment Targets to End Its HIV Epidemic

> **NIH NIH R56** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2020 · $644,436

## Abstract

PROJECT SUMMARY / ABSTRACT
Botswana aspires to end its HIV epidemic, one of the most severe in the world, by 2030. To do so, it plans, by
2023, to reach the UNAIDS 95 95 95 treatment targets; 95% of people living with HIV (PLHIV) diagnosed, 95%
of diagnosed people in treatment, and 95% of treated people virally suppressed (together termed the Treatment
Cascade, TC). Under these treatment targets, UNAIDS elimination goals are to achieve a treatment coverage of
90% and a prevalence of viral suppression (PVS) of 86%. UNAIDS estimates from 2018, however, suggest that
Botswana is far from where it wants to be, with treatment coverage at only 67% and a PVS of 65%. This project,
a collaboration between US investigators and Botswana's ACHAP (African Comprehensive HIV/AIDS
Partnerships) aims to work with the Government of Botswana (GB) to help achieve these targets/goals by
conducting a series of analyses centered on a new dataset, the 2020 Botswana AIDS Impact Survey (BAIS V).
These analyses will enable us to complete three aims: (1) Quantify the current severity of the HIV epidemic in
Botswana: (a) estimating the burden of disease, mapping geographic variation in the severity of the epidemic,
and identifying HotSpots and ColdSpots of prevalence and factors that potentially explain their existence, and
(b) identifying risk, and protective, factors associated with acquiring infection. (2) Determine how close Botswana
is to achieving the 95 95 95 treatment targets: (a) estimating current levels of treatment coverage and the PVS
throughout the country and at the level of local healthcare districts (HCDs), and predicting fine-scale geographic
variation in coverage and PVS, (b) identifying the level, and geographic location, of failures in the TC throughout
Botswana, and (c) identifying individual-level, community-level and structural factors that are associated with,
and barriers to, accessing the continuum of care (from diagnosis, to treatment, to achieving viral suppression).
(3) Test the hypotheses that high rates of Internal Migration of the General Population (IMGP) and/or geographic
inaccessibility of healthcare are major barriers to reaching UNAIDS' treatment coverage goal. We will both
quantify (using spatial error regression models) the effects of high rates of IMGP and distance to healthcare
(defined in terms of travel-time) on limiting treatment coverage throughout Botswana, and provide the first
country-level test that one or both factors are major barriers to HIV elimination. The project will rapidly provide
results to the GB, leveraging ACHAP's central role in Botswana's HIV programs to obtain an immediate impact.

## Key facts

- **NIH application ID:** 10241815
- **Project number:** 1R56AI152759-01A1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Sally Margaret Blower
- **Activity code:** R56 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $644,436
- **Award type:** 1
- **Project period:** 2020-09-02 → 2022-08-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10241815

## Citation

> US National Institutes of Health, RePORTER application 10241815, Helping Botswana Achieve UNAIDS Treatment Targets to End Its HIV Epidemic (1R56AI152759-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10241815. Licensed CC0.

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