Sunpath, HHatlen, T JNaidu, K KMsimango, PAdams, R NMoosa, M-Y SMarconi, V CMurphy, R AGandhi, R TPillay, SSiedner, MNaidoo, K2025-03-022025-03-022018-12-18Sunpath H, Hatlen TJ, Naidu KK, Msimango P, Adams RN, Moosa MS, Marconi VC, Murphy RA, Gandhi RT, Pillay S, Siedner M, Naidoo K. Targeting the third '90': introducing the viral load champion. Public Health Action. 2018 Dec 21;8(4):225-231. doi: 10.5588/pha.18.0063. PMID: 30775284; PMCID: PMC6361489.https://pubmed.ncbi.nlm.nih.gov/30775284/https://doi.org/10.5588/pha.18.0063https://hdl.handle.net/11288/598165Objective: To move closer to achieving the third target of the UNAIDS 90-90-90 goals, we prospectively implemented a viral load (VL) champion (VLC) program aimed at enhancing VL monitoring and recognition of treatment failure. Design: Three clinics in eThekwini, Kwa-Zulu Natal (low-, medium- and high-volume, encompassing 9184 patients overall) were each assigned a VLC. We employed a descriptive analysis (chart audit) to compare the pre-intervention period to a 1-year post-intervention period. The number of patients with a VL test performed 6 and 12 months after the intervention was calculated as a proportion of VL tests due at those time points (VL completion rate). Results: The pre-implementation VL completion rate at the three sites was respectively 68% (140/205 patients), 54% (84/155 patients) and 64% (323/504 patients), and the 6-month post-implementation completion rate increased to 83% (995/1194 patients), 90% (793/878 patients) and 99% (3101/3124 patients) (P < 0.0001 for each site). VL completion rates remained significantly higher at 12 months post-implementation, with an average cumulative VL completion rate of >90% across all facilities. Conclusion: We demonstrate a successful, multifaceted, quality-improvement intervention centered on a clinic-level VLC which, taken to scale, has important implications for attaining the third UNAIDS 90-90-90 target.enAIDSHIVSouth Africaclinical championArticle