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We assessed the progress towards these targets from 2014 to 2016 in South Africa as expanded treatment policies were introduced using population\u2010representative surveys.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected in January to March 2014 and August to November 2016 in Dr. Ruth Segomotsi Mompati District, North West Province. Each multi\u2010stage cluster sample included 46 enumeration areas (<jats:styled-content style=\"fixed-case\">EA<\/jats:styled-content>), a target of 36 dwelling units (<jats:styled-content style=\"fixed-case\">DU<\/jats:styled-content>) per <jats:styled-content style=\"fixed-case\">EA<\/jats:styled-content>, and a single resident aged 18 to 49 per <jats:styled-content style=\"fixed-case\">DU<\/jats:styled-content>. Data collection included behavioural surveys, rapid <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> antibody testing and dried blood spot collection. We used weighted general linear regression to evaluate differences in the <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> care continuum over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 1044 and 971 participants enrolled in 2014 and 2016 respectively with approximately 77% undergoing <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing. Despite increases in reported testing, known status among people living with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">PLHIV<\/jats:styled-content>) remained similar at 68.7% (95% Confidence Interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>)\u00a0=\u00a060.9\u201375.6) in 2014 and 72.8% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a063.6\u201380.4) in 2016. Men were consistently less likely than women to know their status. Among those with known status, <jats:styled-content style=\"fixed-case\">PLHIV<\/jats:styled-content> on <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> increased significantly from 80.9% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a071.9\u201387.4) to 91.5% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a084.4\u201395.5). Viral suppression (&lt;5000 copies\/mL using DBS) among those on <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> increased significantly from 55.0% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a039.6\u201370.4) in 2014 to 81.4% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a072.0\u201390.8) in 2016. Among all <jats:styled-content style=\"fixed-case\">PLHIV<\/jats:styled-content> an estimated 72.0% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a063.8\u201380.1) of women and 45.8% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a027.0\u201364.7) of men achieved viral suppression by 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Over a period during which fixed\u2010dose combination was introduced, <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> eligibility expanded, and efforts to streamline treatment were implemented, major improvements in the second and third 90\u201090\u201090 targets were achieved. Achieving the first 90 target will require targeted and improved testing models for men.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25295","type":"journal-article","created":{"date-parts":[[2019,6,13]],"date-time":"2019-06-13T06:25:30Z","timestamp":1560407130000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Improvements in the South African <scp>HIV<\/scp> care cascade: findings on 90\u201090\u201090 targets from successive population\u2010representative surveys in North West Province"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3152-9372","authenticated-orcid":false,"given":"Sheri A","family":"Lippman","sequence":"first","affiliation":[{"name":"Center for AIDS Prevention Studies Department of Medicine University of California San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison M","family":"El Ayadi","sequence":"additional","affiliation":[{"name":"Bixby Center for Global Reproductive Health Department of Obstetrics, Gynecology and Reproductive Sciences University of California San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica S","family":"Grignon","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington Seattle WA USA"},{"name":"International Training and Education Center for Health (I\u2010TECH) South Africa Pretoria Republic of South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Puren","sequence":"additional","affiliation":[{"name":"Centre for HIV and STIs National Institute for Communicable Diseases\/NHLS Division of Virology School of Pathology University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teri","family":"Liegler","sequence":"additional","affiliation":[{"name":"HIV\/AIDS Division Department of Medicine HIV, Infectious Diseases and Global Health Division University of California San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W D Francois","family":"Venter","sequence":"additional","affiliation":[{"name":"Wits Reproductive Health and HIV Institute (WRHI) Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary J","family":"Ratlhagana","sequence":"additional","affiliation":[{"name":"International Training and Education Center for Health (I\u2010TECH) South Africa Pretoria Republic of South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L","family":"Morris","sequence":"additional","affiliation":[{"name":"Center for AIDS Prevention Studies Department of Medicine University of California San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evasen","family":"Naidoo","sequence":"additional","affiliation":[{"name":"International Training and Education Center for Health (I\u2010TECH) South Africa Pretoria Republic of South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Agnew","sequence":"additional","affiliation":[{"name":"Center for AIDS Prevention Studies Department of Medicine University of California San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Barnhart","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Starley B","family":"Shade","sequence":"additional","affiliation":[{"name":"Center for AIDS Prevention Studies Department of Medicine University of California San Francisco CA USA"},{"name":"Institute for Global Health Science Department of Epidemiology and Biostatistics University of California San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105243"},{"key":"e_1_2_9_3_1","unstructured":"UNAIDS.90\u201090\u201090: An ambitious treatment target to help end the AIDS epidemic. 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