--- title: "UNAIDS 95-95-95 progress among adolescents and young adults in sub-Saharan Africa: systematic revi" id: "bmj-open-0-hiv-care-cascade-of-adolescents-and-young-adults-in-sub-saharan-africa-a" canonical_url: "https://medichelpline.com/clinical-feed/bmj-open-0-hiv-care-cascade-of-adolescents-and-young-adults-in-sub-saharan-africa-a" content_type: "clinical_feed_article" specialty: "Infectious Disease" source_name: "BMJ Open" source_url: "http://bmjopen.bmj.com/cgi/content/short/16/10/e107159?rss=1" published_at: "2026-10-07T11:48:05.000Z" evidence_level: "Journal Feed" license: "CC-BY-NC-4.0 / Informational Use" --- # UNAIDS 95-95-95 progress among adolescents and young adults in sub-Saharan Africa: systematic revi ## Provenance & Clinical Metadata - **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-open-0-hiv-care-cascade-of-adolescents-and-young-adults-in-sub-saharan-africa-a - **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md) - **Primary Source:** BMJ Open - **Source URL:** [Original Journal Publication](http://bmjopen.bmj.com/cgi/content/short/16/10/e107159?rss=1) - **Published At:** 2026-10-07T11:48:05.000Z - **Evidence Rating:** Journal Feed ## Executive GIST (TL;DR) - This systematic review and meta-analysis assessed progress toward the **UNAIDS 95‑95‑95** targets among **adolescents and young adults (AYA)** living with HIV in sub‑Saharan Africa (SSA). - Searches spanned multiple bibliographic databases and grey literature, targeting articles published from 2015 to 2025 that reported at least one cascade outcome. - The review followed PRISMA guidance; screening used Rayyan software and data extraction was performed independently for included studies. - Pooled estimates were produced using random‑effects models and WHO age bands for AYA (10–14, 15–19, 20–24 years); supplementary analyses used study age bands when reported. - From 8,435 records, 220 full texts were screened and 37 studies from 13 SSA countries met inclusion criteria. - Nearly half of included studies reported only one cascade outcome; 13 studies (40%) reported all three UNAIDS cascade outcomes. - Pooled cascade results for all AYAs were 73% aware of HIV status, 84% of those diagnosed initiated **antiretroviral treatment (ART)**, and 71% of those on ART achieved **viral load suppression**. - For the 15–24 year age group, pooled estimates were 73% diagnosed, 83% initiated ART, and 82% virally suppressed (pooled proportions with reported 95% CIs in source). - The review highlights persistent gaps across the UNAIDS cascade for AYA in SSA and calls for AYA‑responsive services to improve early diagnosis, linkage, retention, and long‑term treatment engagement. - The review emphasizes the need for standardised definitions aligned with UNAIDS recommendations and reports PROSPERO registration CRD42024561024. ## Clinical Analysis & Structured Key Points Objectives Tracking the progress of the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95 - 95 - 95 targets is essential for evaluating HIV programme performance and improving outcomes across all subpopulations, age groups and geographical settings. We conducted a systematic review and synthesis of the UNAIDS 95 - 95 - 95 targets among adolescents and young adults (AYA) living with HIV in sub-Saharan Africa (SSA). Design The systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Data sources The search was conducted from the following databases: PubMed/MEDLINE, Embase, Scopus, CINAHL, African Index Medicus (AIM) and African Journals Online (AJOL) and grey literature sources. Eligibility criteria Articles that were published from 2015 to 2025 reported progress on at least one of the 95 - 95 - 95 targets were searched. We performed meta-analysis using WHO-defined AYA age bands (10 - 14, 15 - 19 and 20 - 24 years) and supplementary analysis of age bands of the included studies. Data extraction and synthesis Full-text articles were downloaded from Rayyan software and data extraction was performed independently for each included study. We pooled independent study estimates and calculated 95% CIs intervals using random-effects models. Risk of bias was assessed at individual study level using the adapted Joanna Briggs Institute (JBI) tool. Results The search yielded 8435 articles, of which 220 were eligible for full-text screening and 37 were included. The studies originated from 13 (South Africa, Uganda, Botswana, Eswatini, Rwanda, Lesotho, Malawi, Cameroon, Democratic Republic of Congo, Ghana, Nigeria, Tanzania and Zimbabwe) SSA countries. The most reported age range 15 - 24 years (n=19, 51%). Half (n=18, 49%) of the studies reported one of three cascade outcomes and (n=13, 40%) all three. The progress toward UNAIDS target for all AYAs was 73 - 84 - 71, pooled proportion of those aware of their HIV-positive status was 73% (95% CI 65% to 81%), 84% (95% CI 77% to 91%) of diagnosed initiated antiretroviral treatment (ART) and 71% (95% CI 64% to 79%), those on ART achieved viral load suppression. The pooled proportion of HIV-positive diagnosed was 73% (95% CI 63% to 82%), 83% (95% CI 75% to 90%) ART initiated and 82% (95% CI 72% to 92%) viral load suppressed for 15 - 24 years old. Conclusion Significant gaps persist throughout the UNAIDS cascade of AYA in SSA. To close these gaps, HIV programmes must prioritise AYA-responsive services that support earlier diagnosis, facilitate linkage and continuity of care and sustain long-term treatment engagement. Standardised definitions aligned with UNAIDS recommendations are essential. 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