A comparison of self-report and antiretroviral detection to inform estimates of antiretroviral therapy coverage, viral load suppression and HIV incidence in Kwazulu-Natal, South Africa

Huerga, Helena; Shiferie, Fisseha; Grebe, Eduard; Giuliani, Ruggero; Farhat, Jihane Ben; Cutsem, Gilles van; Cohen, Karen

doi:10.1186/s12879-017-2740-y

Cited by 35 publications

(38 citation statements)

References 11 publications

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“…HIV status-awareness and ART coverage are based on participants’ responses to the survey questionnaire. These two indicators might be underestimated if HIV-positive participants were unwilling to report knowing their HIV status, which might be the case among adolescents in particular ( 7 ). Multiplying the three 90/90/90 target measures from this analysis together (46.3% aware of HIV-positive status x 85.5% self-reported ART use x 81.8% viral suppression among those on ART) produces a viral load suppression prevalence among HIV-positive adolescent girls and young women on ART of 32.4%.…”

Section: Discussionmentioning

confidence: 99%

Status of HIV Epidemic Control Among Adolescent Girls and Young Women Aged 15–24 Years — Seven African Countries, 2015–2017

Brown¹,

Williams²,

Kinchen³

et al. 2018

MMWR Morb. Mortal. Wkly. Rep.

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Section: Discussionmentioning

confidence: 99%

Status of HIV Epidemic Control Among Adolescent Girls and Young Women Aged 15–24 Years — Seven African Countries, 2015–2017

Brown¹,

Williams²,

Kinchen³

et al. 2018

MMWR Morb. Mortal. Wkly. Rep.

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“…To obtain contextual epidemiological parameters, the survey data was analysed to obtain prevalence and treatment coverage proportions, and an initial incidence analysis was conducted, using a standard RITA comprising LAg (≤ 1.5) and viral load (> 100 copies/ml), with MDRI and a crude FRR estimated from CEPHIA data, to obtain an overall incidence in the population of interest. ARV testing was not included in the RITA, as this may have an unknown impact on MDRI, and earlier work using this survey demonstrated limited benefit for FRR and precision of incidence estimates [21]. April 26, 2018 15/26…”

Section: Resultsmentioning

confidence: 99%

Population-level HIV incidence estimates using a combination of synthetic cohort and recency biomarker approaches in KwaZulu-Natal, South Africa

Grebe

Welte

Johnson

et al. 2018

Preprint

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Introduction: There is a notable absence of consensus on how to generate estimates of population-level incidence. Incidence is a considerably more sensitive and harder to estimate indicator of epidemiological trends than prevalence. We used a novel hybrid method to estimate HIV incidence by age and sex in a rural district of KwaZulu-Natal, South Africa.Methods: Our novel method uses an 'optimal weighting' of estimates based on an implementation of a particular 'synthetic cohort' approach (interpreting the age/time structure of prevalence, in conjunction with estimates of excess mortality) and biomarkers of 'recent infection' (combining Lag-Avidity, Bio-Rad Avidity and viral load results to define recent infection, and adapting the method for age-specific incidence estimation). Data were obtained from a population-based cross-sectional HIV survey conducted in Mbongolwane and Eshowe health service areas in 2013.

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“…STI prevalence is 13%, and young women under age 25 are at significantly higher risk . About 77% of men have not been circumcised , and while viral suppression among those on medication was high among teenagers (68%) and 20‐ to 24‐year olds (87%), overall, ART use was less than 45% among those aged 15 to 34 .…”

Section: Discussionmentioning

confidence: 99%

Contextual drivers of HIV risk among young African women

Mojola

Wamoyi

2019

J Intern AIDS Soc

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Introduction Significant progress has been made in the African HIV pandemic; however, the pace of incidence decline has slowed or stalled in many East and Southern African countries, especially among young women. This stall is worrying because many countries have burgeoning youth populations. There is an important window of opportunity to halt the epidemic as well as the potential for millions more infections if primary prevention efforts are not strengthened. Discussion Many hyper‐endemic settings have been exposed to numerous interventions; however, HIV incidence among young women has remained high. In this paper, we characterize the intervention context and examine how it can be strategically utilized to maximize HIV prevention interventions among young women. We begin by examining how contextual dynamics drive HIV risk. We illustrate how epidemiological contexts, gendered normative and economic contexts, and environmental contexts work synergistically to make young women especially vulnerable to HIV infection. We then examine how these contexts can undermine HIV prevention interventions. Finally, we discuss the importance of fully mapping out the intervention context to enhance the effectiveness of HIV prevention interventions. Conclusions Understanding an intervention context, and how its features work together to amplify young women's risk in hyper‐endemic settings can contribute to sustained momentum in reducing HIV incidence among young women and help to limit the reach of the HIV pandemic into new generations of Africans.

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A comparison of self-report and antiretroviral detection to inform estimates of antiretroviral therapy coverage, viral load suppression and HIV incidence in Kwazulu-Natal, South Africa

Cited by 35 publications

References 11 publications

Status of HIV Epidemic Control Among Adolescent Girls and Young Women Aged 15–24 Years — Seven African Countries, 2015–2017

Status of HIV Epidemic Control Among Adolescent Girls and Young Women Aged 15–24 Years — Seven African Countries, 2015–2017

Population-level HIV incidence estimates using a combination of synthetic cohort and recency biomarker approaches in KwaZulu-Natal, South Africa

Contextual drivers of HIV risk among young African women

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