Profiles and outcomes of untreated people with HIV in French Guiana: progress towards 95-95-95 targets

BACKGROUND: Although treatment is recommended for all people living with HIV, not all individuals in the French Guiana cohort were receiving antiretroviral therapy (ART). We aimed to describe trends and characteristics of people living with HIV who were not receiving ART in French Guiana. METHODS: We conducted a retrospective cohort study evaluating the most recent treatment status and associated variables. RESULTS: Between 2016 and 2023, there were 246 (6.1%) persons who had stopped ART at last news, 527 (13%) who were ART naive, and 3283 (80.9%) who were on ART. Over time, the proportion of treated individuals increased (+ 8% per year after 2010), while the proportions of ART-naive individuals (-3% per year) and treatment interruptions (-2% per year since 2017) declined. ART-naive individuals were less likely to report drug use (0.4%) compared with those on treatment (3.6%) or those who had stopped treatment (8.5%, P < 0.0001). The viral load among those not receiving treatment gradually declined. Persons having stopped treatment were older and more immunosuppressed. Remaining ART-naive persons were younger and had higher CD4 counts. Individuals who were ART-naive or who had interrupted treatment had the highest mortality. CONCLUSIONS: The proportion of untreated persons has been gradually decreasing towards the target of 95% on treatment.