Progress Towards UNAIDS 95-95-95 Targets Among People Living with HIV (PLHIV): A Longitudinal Analysis from Uttarakhand, India (2020–2025)

Abstract

Background: The UNAIDS 95-95-95 framework represents the global benchmark for ending the AIDS epidemic by 2030. India, with approximately 2.35 million people living with HIV (PLHIV), faces significant regional heterogeneity in achieving these targets. Uttarakhand — a Himalayan state characterised by low HIV prevalence, dispersed population, and terrain-related structural barriers — remains underrepresented in sub-national HIV research.
Objectives: To compare Uttarakhand's performance on the three 95-95-95 indicators with national averages (2020–2025), assess temporal trends, and estimate the gap between current performance and the UNAIDS targets.
Methods: A retrospective longitudinal descriptive study was conducted using secondary programmatic data from the National AIDS Control Organization (NACO) Annual Reports and the NACO Sankalak Report, 7th Edition (2025). Descriptive statistics and arithmetic projection modelling [Pₜ = P₀(1 + rt)] were applied.
Results: Uttarakhand's First 95 (diagnosis) improved from 51.1% (2020-21) to 76.3% (2024-25), yet trailed the national average (83.9%), leaving an 18.7 percentage-point gap. The Second 95 (ART coverage) reached 77.9% versus the national 86.6%, a 17.1 percentage-point deficit. Remarkably, the Third 95 (viral suppression) was achieved at 95% by 2023-24. District-level analysis identified Haridwar and Udham Singh Nagar as moderate-burden districts.
Conclusion: While Uttarakhand has achieved the viral suppression target, critical gaps persist in diagnosis and ART coverage. Intensified case-finding, linkage-to-care strategies, and district-targeted interventions are urgently needed to meet the 2030 elimination goal.