Billioux, Veena G.Chang, Larry W.Reynolds, Steven J.Nakigozi, GertrudeSsekasanvu, JosephGrabowski, Mary K.Ssekubugu, RobertNalugoda, FredKigozi, GodfreyKagaayi, JosephSerwadda, DavidGray, Ronald H.Wawer, Maria J.2022-03-112022-03-112017Billioux, V. G., Chang, L. W., Reynolds, S. J., Nakigozi, G., Ssekasanvu, J., Grabowski, M. K., ... & Rakai Health Sciences Program. (2017). Human immunodeficiency virus care cascade among sub‐populations in Rakai, Uganda: an observational study. Journal of the International AIDS Society, 20(1), 21590. http://dx.doi.org/10.7448/IAS.20.1.21590http://dx.doi.org/10.7448/IAS.20.1.21590https://nru.uncst.go.ug/xmlui/handle/123456789/2679To assess progress towards the UNAIDS 90–90–90 initiative targets, we examined the HIV care cascade in the population-based Rakai Community Cohort Study (RCCS) in rural Uganda and examined differences between sub-groups. Methods: Self-reports and clinical records were used to assess the proportion achieving each stage in the cascade. Statistical inference based on a 2 test for categorical variables and modified Poisson regression were used to estimate prevalence risk ratios (PRRs) and 95% confidence intervals (CI) for enrolment into care and initiating antiretroviral therapy (ART). Results: From September 2013 through December 2015, 3,666 HIV-positive participants were identified in the RCCS. As of December 2015, 98% had received HIV Counseling and Testing (HCT), 74% were enrolled in HIV care, and 63% had initiated ART of whom 92% were virally suppressed after 12 months on ART. Engagement in care was lower among men than women (enrolment in care: adjPRR 0.84, 95% CI 0.77–0.91; ART initiation: adjPRR 0.75, 95% CI 0.69–0.82), persons aged 15–24 compared to those aged 30–39 (enrolment: adjPRR 0.72, 95% CI 0.63–0.82; ART: adjPRR 0.69, 95%CI 0.60–0.80), unmarried persons (enrolment: adjPRR 0.84, 95% CI 0.71–0.99; ART adjPRR 0.80, 95% CI 0.66–0.95), and new in-migrants (enrolment: adjPRR 0.75, 95% CI 0.67–0.83; ART: adjPRR 0.76, 95% CI 0.67–0.85). This cohort achieved 98–65–92 towards the UNAIDS “90–90–90” targets with an estimated 58% of the entire HIV-positive RCCS population virally suppressed. Conclusions: This cohort achieved over 90% in both HCT and viral suppression among ART users, but only 65% in initiating ART, likely due to both an ART eligibility criterion of <500 CD4 cells/mL and suboptimal entry into care among men, younger individuals, and in-migrants. Interventions are needed to promote enrolment in HIV care, particular for hard-to-reach subpopulations.enHIVAntiretroviralHIV care cascadeRakaiUgandaArticle