According to UNAIDS data, two-thirds of people living with HIV and most new HIV infections are in sub-Saharan Africa. As such, effective strategies to curtail the burden of infection should target this region. Based on current UNAIDS key performance indicators to evaluate strategies for global HIV control (90% of people with HIV aware of their status, antiretroviral therapy for 90% of those diagnosed, and 90% viral suppression in those treated by 2020; and 95% by 2030 if the 90% objectives were achieved in 2020), 1 UNAIDS
Ending AIDS: progress towards the 90–90–90 targets. Africa is the region with the poorest indicators, especially in the key population of men who have sex with men (MSM). 2 Stannah J Dale E Elmes J et al. HIV testing and engagement with the HIV treatment cascade among men who have sex with men in Africa: a systematic review and meta-analysis.

Lancet HIV. 2019; 6: e769-e787

In sub-Saharan Africa, among MSM living with HIV, only 24% were on antiretroviral therapy, of whom, only 25% were virally suppressed, 2 Stannah J Dale E Elmes J et al. HIV testing and engagement with the HIV treatment cascade among men who have sex with men in Africa: a systematic review and meta-analysis.

Lancet HIV. 2019; 6: e769-e787

highlighting the need for more effective, aggressive, and proactive strategies to reduce the burden of HIV in this group. Of these strategies, pre-exposure prophylaxis (PrEP) seems most promising in this population, which has the second highest incidence of HIV on the continent. 1 UNAIDS
Ending AIDS: progress towards the 90–90–90 targets.