Juliet Pulliam has recently taken over from Alex Welte as director of SACEMA. In this issue, she reflects on the challenges – and many exciting opportunities – ahead.
The World Health Organization’s most recent guideline for the treatment of HIV recommends ART for all individuals living with HIV. Although this new recommendation is gaining traction among wealthier countries, many countries have not yet adopted this guideline. Instead, those countries follow a strategy of providing ART only to people with low CD4+ T-cell counts, which was necessary early in the HIV epidemic, but it is unclear whether the use of CD4 counts was based on sound science and logic.
Effective HIV prevention requires knowledge of the structure and dynamics of the social networks across which infections are transmitted. These networks are most commonly comprised of chains of sexual relationships. Whereas network data have long been collected during survey interviews, new data sources have become increasingly common in recent years. In this article, we review current and emerging methods for collecting HIV-related network data, as well as modelling frameworks commonly used to infer network parameters and map potential HIV transmission pathways within the network.
World-wide South Africa has the largest epidemic of HIV and the biggest anti-retroviral programme. But reaching the UNAIDS 90-90-90 target by 2020 and ending AIDS by 2030 will require an expansion of surveillance and strengthening patient monitoring. Both are needed to monitor progress, identify and correct problems and to demonstrate success. Here we outline the current state of the epidemic and discuss important issues that should inform the National Strategic Plan to be launched on World AIDS Day in December.
Common indicators such as the number of new sexual partners in a given year and the lifetime number of sexual partners are used in several analyses to predict the risk of contracting HIV. However, are these indicators consistent?
Intimate partner violence (IPV) is a public health problem that has drawn considerable research attention over the last few decades. Studies that have looked at age disparity as a risk factor of IPV show conflicting results regarding the direction of the association. It is due to these conflicting results that we sought to investigate if having an older partner is protective against IPV, compared to having a partner of closer age, in Sub-Saharan Africa using data from Demographic Health Surveys.
In the last week of June 2016, fifteen scientists converged on Stellenbosch for a week-long intensive workshop, hosted by SACEMA, aimed at sharing their knowledge of the problems and prospects associated with modelling the population dynamics of tsetse flies (Glossina spp) and the trypanosomes that they transmit in Africa to game animals, domestic livestock and humans.
The annual ‘Research Days’ meeting in Stellenbosch, to which all SACEMA funded students and their supervisors are invited, was this year extended to a four day training and research event and took place from 11 to 14 April 2016.
Having been involved in SACEMA since the start, and as director since 2010, Alex Welte is stepping aside to focus on research at the end of June 2016. In this article he shares his reflections on his time at SACEMA, so far.
With the release of the WHO Consolidated Strategic Information Guidelines , countries are provided with a template, in the form of a depiction of the “Care Cascade”, permitting them to quantify the state of care as it currently stands. The Care Cascade begins by characterising all infected individuals in a population, before illustrating the cascading loss of patients at each stage of care between diagnosis and viral suppression. Countries are now beginning to produce estimates of their national cascades in order to evaluate the efficiency of current care programmes. This article discusses data issues related to cascade reporting and suggests ways to improve reporting.