Will the current National Strategic Plan enable South Africa to end AIDS, Tuberculosis and Sexually Transmitted Infections by 2022?

Hopkins, Kathryn L.; Doherty, Tanya; Gray, Glenda

doi:10.4102/sajhivmed.v19i1.796

Cited by 13 publications

(8 citation statements)

References 19 publications

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“…Our findings therefore support calls to focus on improving the quality of HIV services [71]. This needs to be rooted within a broader multisectoral response, informed by high quality transdisciplinary research, that addresses the social and structural drivers of the epidemic [72].…”

Section: Discussionsupporting

confidence: 56%

Trends in Pretreatment HIV-1 Drug Resistance in Antiretroviral Therapy-naive Adults in South Africa, 2000–2016: A Pooled Sequence Analysis

et al. 2019

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Background South Africa has the largest public antiretroviral therapy (ART) programme in the world. We assessed temporal trends in pretreatment HIV-1 drug resistance (PDR) in ART-naïve adults from South Africa. Methods We included datasets from studies conducted between 2000 and 2016, with HIV-1 pol sequences from more than ten ART-naïve adults. We analysed sequences for the presence of 101 drug resistance mutations. We pooled sequences by sampling year and performed a sequence-level analysis using a generalized linear mixed model, including the dataset as a random effect. Findings We identified 38 datasets, and retrieved 6880 HIV-1 pol sequences for analysis. The pooled annual prevalence of PDR remained below 5% until 2009, then increased to a peak of 11·9% (95% confidence interval (CI) 9·2-15·0) in 2015. The pooled annual prevalence of non-nucleoside reverse-transcriptase inhibitor (NNRTI) PDR remained below 5% until 2011, then increased to 10.0% (95% CI 8.4–11.8) by 2014. Between 2000 and 2016, there was a 1.18-fold (95% CI 1.13–1.23) annual increase in NNRTI PDR (p < 0.001), and a 1.10-fold (95% CI 1.05–1.16) annual increase in nucleoside reverse-transcriptase inhibitor PDR (p = 0.001). Interpretation Increasing PDR in South Africa presents a threat to the efforts to end the HIV/AIDS epidemic. These findings support the recent decision to modify the standard first-line ART regimen, but also highlights the need for broader public health action to prevent the further emergence and transmission of drug-resistant HIV. Source of Funding This research project was funded by the South African Medical Research Council (MRC) with funds from National Treasury under its Economic Competitiveness and Support Package. Disclaimer The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of CDC.

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Section: Discussionsupporting

confidence: 56%

Trends in Pretreatment HIV-1 Drug Resistance in Antiretroviral Therapy-naive Adults in South Africa, 2000–2016: A Pooled Sequence Analysis

et al. 2019

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“…Younger women (aged 15–24 years) tend to have age-disparate partners (5+ years senior), with the odds of HIV infection increasing for each year increase in the male partner’s age 57. Once older, these infected women have same-age relationships, infecting their male partners, who in turn infect younger women 58 59. Furthermore, global data depict older women sharing many of the same risk factors for HIV as younger women, including lack of HIV prevention knowledge, having multiple sex partners (if divorced or widowed) and less likely to practice safer sex due to being postmenopausal and not of reproductive age 60.…”

Section: Discussionmentioning

confidence: 99%

Demographics and health profile on precursors of non-communicable diseases in adults testing for HIV in Soweto, South Africa: a cross-sectional study

et al. 2019

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ObjectivesThis cross-sectional study investigated the burden of HIV-non-communicable disease (NCD) precursor comorbidity by age and sex. Policies stress integrated HIV-NCD screenings; however, NCD screening is poorly implemented in South African HIV testing services (HTS).SettingWalk-in HTS Centre in Soweto, South Africa.Participants325 voluntary adults, aged 18+ years, who provided written or verbal informed consent (with impartial witness) for screening procedures were enrolled.Primary and secondary outcomesData on sociodemographics, tuberculosis and sexually transmitted infection symptoms, blood pressure (BP) (≥140/90=elevated) and body mass index (<18.5 underweight; 18.5–25.0 normal; >25 overweight/obese) were stratified by age-group, sex and HIV status.ResultsOf the 325 participants, the largest proportions were female (51.1%; n=166/325), single (71.5%; n=231/323) and 25–34 years (33.8%; n=110/325). Overall, 20.9% (n=68/325) were HIV infected, 27.5% (n=89/324) had high BP and 33.5% (n=109/325) were overweight/obese. Among HIV-infected participants, 20.6% (14/68) had high BP and 30.9% (21/68) were overweight/obese, as compared with 29.3% (75/256) and 12.1% (31/256) of the HIV-uninfected participants, respectively. Females were more likely HIV-infected compared with males (26.5% (44/166) vs 15.1% (24/159); p=0.012). In both HIV-infected and uninfected groups, high BP was most prevalent in those aged 35–44 years (25% (6/24) vs 36% (25/70); p=0.3353) and >44 years (29% (4/14) vs 48% (26/54); p=0.1886). Males had higher BP than females (32.9% (52/158) vs 22.3% (37/166); p=0.0323); more females were overweight/obese relative to males (45.8% (76/166) vs 20.8% (33/159); p<0.0001). Females were more likely to be HIV infected and overweight/obese.ConclusionAmong HTS clients, NCD precursors rates and co-morbidities were high. Elevated BP occurred more in older participants. Targeted integrated interventions for HIV-infected females and HIV-infected people aged 18–24 and 35–44 years could improve HIV public health outcomes. Additional studies on whether integrated HTS will improve the uptake of NCD treatment and improve health outcomes are required.

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“…In May 2017, the South African National AIDS Council released the fourth National Strategic Plan (NSP) for HIV, Tuberculosis and Sexually Transmitted Infections Plan. The goal of the five-year plan (2017-2022) is to track progress towards eliminating HIV as a public health threat by the year 2030 [45], and to oversee the implementation of an HIV strategy for adolescent and young women and girls (AYWG). While the AYWG strategy is laudable, it does not expressly focus on the need to reduce or eliminate HIV-related stigma among this population.…”

Section: National Hiv/aids Policies and Strategiesmentioning

confidence: 99%

HIV Stigma among Women and Adolescent Girls in South Africa: Removing Barriers to Facilitate Prevention

Armstrong-Mensah¹,

Hernández²,

Huka³

et al. 2019

Madridge J AIDS

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HIV-related stigma is a global issue. Its perpetuation varies in magnitude across and within countries, and serves as a major barrier to HIV prevention efforts. Due to ignorance about the disease in sub-Saharan Africa, people living with HIV are often stigmatized, and as a result, experience dire consequences. In South Africa, women and adolescent girls are disproportionately infected by HIV. The stigma associated with HIV causes them to live in constant fear of discrimination, isolation, and violence from community members. The stigma also causes them to conceal their HIV status from family members, spouses, or partners, and thus, thwarts any chances of health seeking behavior that can improve upon their quality of life or prevent future transmissions. The stigma associated with HIV impacts women and adolescent girls in South Africa socially, economically and mentally. Given that women and adolescent girls are the population with the greatest HIV prevalence in South Africa, and given that prevention efforts cannot be as successful without addressing the issue of stigma among this group, deliberate commitment and an integrated approach from the government, healthcare professionals, public health officials, and communities are needed to stem the HIV tide in South Africa. These entities need to work together to create an environment where women and adolescent girls feel safe enough to disclose their HIV status and participate in prevention efforts. This article discusses HIV stigma among women and adolescent girls in South Africa. It presents some risk factors that predispose this population in South Africa to HIV, and highlights the social, economic and mental health effects of HIV-related stigma on them. The article further examines current efforts in South Africa to address HIV-related stigma among women and adolescent girls and proffers recommendations for eliminating stigma in order to pave way for effective national HIV prevention.

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Will the current National Strategic Plan enable South Africa to end AIDS, Tuberculosis and Sexually Transmitted Infections by 2022?

Cited by 13 publications

References 19 publications

Trends in Pretreatment HIV-1 Drug Resistance in Antiretroviral Therapy-naive Adults in South Africa, 2000–2016: A Pooled Sequence Analysis

Trends in Pretreatment HIV-1 Drug Resistance in Antiretroviral Therapy-naive Adults in South Africa, 2000–2016: A Pooled Sequence Analysis

Demographics and health profile on precursors of non-communicable diseases in adults testing for HIV in Soweto, South Africa: a cross-sectional study

HIV Stigma among Women and Adolescent Girls in South Africa: Removing Barriers to Facilitate Prevention

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