Review of UNAIDS national estimates of men who have sex with men, gay dating application users, and 90-90-90 data

Background Achieving the 90-90-90 is essential to keep people alive and to end AIDS. Men who have sex with men (MSM) often have the least access to HIV services. Purpose Estimates for key populations are often unavailable, dated or have very wide confidence intervals and more accurate estimates are required. Methods We compared registered users from a major gay dating application (2016) from 29 countries with the latest available (2013-2016) UNAIDS estimates by country. We searched the Internet, PubMed, national surveillance reports, UNAIDS country reports, President’s Emergency Plan for AIDS Relief (PEPFAR) 2016 and 2017 operational plans, and conference abstracts for the latest nationally representative continua for MSM. Results Of comparison countries, only 18 countries had UNAIDS or other MSM population estimates in the public domain. UNAIDS estimates were larger than the gay dating application users in 9 countries, perhaps reflecting incomplete market penetration for the application. The gay dating application users in 9 countries were above the UNAIDS estimates; 8 were over 30% higher and three more than double the reported estimate. Seven partial or complete nationally representative care continua for MSM were published between 2010 and 2016. Among estimated MSM living with HIV, viral suppression varied between 42% (United States) to 99% (Denmark). The quality of the continua methods varied (quality data not shown). Conclusion “What is not monitored is not done” and social media has significant promise to improve estimates to ensure that MSM and other vulnerable people living with HIV and their communities are not left behind on the way to ending AIDS.