Campaigners for fourth ‘90’ welcome inclusion of quality of life in new UNAIDS survey


  • Jo Whelan
  • Medical News
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The new UNAIDS 82-question online survey features questions on health-related quality of life (HRQL), the first time this topic has been addressed according to a new report in The Lancet. The move has been welcomed by those who believe that a fourth ‘90’, denoting that 90% of people with viral load suppression have good HRQL, should be added to the current UNAIDS ’90-90-90’ target (90% diagnosis of HIV, 90% treatment, and 90% viral suppression in each country).

  • The survey is aimed at lesbian, gay, bisexual, trans, and intersex (LGBTI) people and is not specific to HIV.
  • It reflects an increasing emphasis on the need to include mental wellness in the planning of public health interventions to combat HIV/AIDS.
  • The fourth ‘90’ was first proposed by Lazarus et al. of The Barcelona Institute for Global Health in 2016. They pointed out that even those with HIV who have attained viral suppression still face challenges such as physical comorbidities, depression, anxiety, financial stress, and HIV-related discrimination.

HRQL-related issues covered in the survey include ‘outness’, family support, sexual satisfaction, physical health, happiness, self-esteem, and the internalisation of homophobia. UNAIDS says it is trying to determine whether scores on these measures are correlated with risk-taking behaviours that drive HIV infection and other health risks. So far, 11% of respondents to the online survey are living with HIV, UNAIDS says.

The LGBT Foundation, based in Manchester, was one of three international groups involved in designing the new questionnaire.

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