HIV viral suppression in Oman: Encouraging progress toward achieving the United Nations 'third 90'.

OBJECTIVE: To assess the impact of capacity-building interventions introduced by the Oman National AIDS Programme on the quality of HIV care in the country.

METHODS: HIV viral load (VL) suppression and loss to follow-up (LTFU) rates were calculated for the period before (in December 2015; n=1098) and after (in June 2017; n=1185) the introduction of the interventions: training, support, and care pathway development. Three HIV VL cuts-offs at last measurement in the year of interest were used to define VL suppression.

RESULTS: In the intention-to-treat (ITT) analysis, rates of VL <200 copies/ml and <1000 copies/ml increased from 51.9% in 2015 to 65.5% in 2017 (relative risk (RR) 1.26, 95% confidence interval (CI) 1.17-1.36) and from 58.1% in 2015 to 70.9% in 2017 (RR 1.22, 95% CI 1.14-1.30), respectively; p<0.0001 for both. Similarly, in the on-treatment analysis, rates of VL <200 copies/ml and <1000copies/ml increased from 64.2% in 2015 to 76.9% in 2017 (RR 1.20, 95% CI 1.12-1.28) and from 71.9% in 2015 to 83.2% in 2017 (RR 1.16, 95% CI 1.10-1.22), respectively. Fewer patients were LTFU in 2017 than in 2015 (14.7% (157/1061) vs. 19.2% (188/981); RR 0.77, 95% CI 0.64-0.94).

CONCLUSIONS: Achieving the UNAIDS target of 90% of HIV patients on treatment having VL suppression by 2020 is feasible in Oman.