2nd Edition of Preventive Medicine World Conference 2026

Abstract

Background: The UNAIDS 95-95-95 targets serve as the global roadmap to ending the AIDS epidemic by 2030. While India has made significant strides, the progress within its diverse states varies due to unique socio-geographic challenges. This study evaluates the HIV care continuum in the Himalayan state of Uttarakhand, specifically comparing its performance against Indian national averages to identify systemic gaps in diagnosis, treatment, and clinical outcomes.

Methodology: A longitudinal secondary data analysis was performed using National AIDS Control Organization (NACO) and Uttarakhand State AIDS Control Society (USACS) datasets (2020–2025). The first pillar (status awareness) was projected using the arithmetic method.Performance was benchmarked against the 95-95-95 targets and national coverage rates using descriptive statistics and district-level prevalence mapping.

Results: Uttarakhand state demonstrated a robust upward trajectory in the First 95, improving from 51.1 percent in 2020-21 to 76.3 percent in 2024-25. However, the state remains 18.7 percent short of the target and consistently trails the national average of 83.9 percent. The Second 95 (ART coverage) fluctuated, reaching 77.9 percent by 2025, significantly lower than the national average of 86.6 percent. In contrast, the state demonstrated clinical excellence in the Third 95, surpassing the viral suppression target at 95 percent since 2023-24, effectively aligning with national success. Spatial analysis revealed moderate-burden clusters in Haridwar and Udhamsingh Nagar, while the remaining nine districts maintained low prevalence.

Conclusion: Uttarakhand presents a unique epidemiological profile: while it has achieved the global benchmark for viral suppression, significant leaks persist in the early stages of the care continuum. The findings suggest that while clinical management of PLHIV is highly effective, decentralized testing and treatment retention remain critical challenges. To achieve the 2030 goals, public health interventions must prioritize intensified case-finding and localized outreach in moderate-burden districts to bridge the disparity between state and national performance.