November 2010

Short item Published on November 30, 2010

Treatment as prevention: the discussion continues

In the first edition of the SACEMA Quarterly (March 2009) Brian Williams provided a discussion on the various arguments for and against the in a Lancet article suggested approach of ‘treatment as prevention’ of HIV (early treatment of HIV infected individuals will prevent transmission of the virus) (1). As this ‘test-and-treat’ strategy continues to be Read More

Short item Published on November 30, 2010

Concurrent sexual partnerships and the HIV epidemic in Africa

The notion that concurrent sexual partnerships (having more than one partner at the same time) are especially common in sub-Saharan Africa and explain the region's high HIV prevalence is accepted by many as conventional wisdom. A systematic review that was recently published was conducted to question this theory. The quantitative and qualitative evidence offered by Read More

Published on November 30, 2010 by


In this last issue of the SACEMA Quarterly in 2010 we present three main articles on a variety of issues: An update on the evidence for the efficacy of microbicides, including the cost-effectiveness of this intervention; The emerging issue of abuse and neglect experienced by AIDS orphans (and other vulnerable children) and their perceived social support; The enormous rise in the prevalence of drug abuse and the increase in the need for treatment. We also have short items providing information on the early work on tsetse by Glyn Vale; An update on the ‘treatment as prevention’ issue; And an item on the issue of the importance of concurrency in the high incidence rate of HIV in Africa. We hope you will all enjoy reading this issue. Next year we will continue publishing the SACEMA Quarterly magazine after giving it a slight makeover.

Published on November 30, 2010 by

Microbicides: the end of the beginning, not the beginning of the end

After two decades of setbacks with microbicide trials, recently two studies demonstrated a proof of concept for microbicides for the first time. With now a demonstrated proof of concept, understanding the potential cost-effectiveness of vaginal microbicides within the currently existing set of HIV prevention interventions becomes crucial. As there it not yet a safe and effective microbicide available, the challenge is to evaluate the potential of the microbicide technology for a hypothetical intervention. Results are reported of a recent study that looked at a potential 1-year intervention targeting a population of women in reproductive age in South Africa and estimated the incremental cost-effectiveness over a year of microbicides when distributed in conjunction with condoms.

Short item Published on November 21, 2010

On the importance of doing things properly

II. Glyn Vale and the birth of the “artificial cow” In a recent poll of British university academics the cracking of the DNA-based genetic code was cited as the most important advance by British scientists during the past 60 years. More surprisingly, voted into eighth-place, just ahead of work on stem cell research, was the Read More

Published on November 21, 2010 by

How supportive is the social network of AIDS orphans and other orphaned children in Conakry and N’Zérékoré, Guinea?

AIDS orphans face far greater financial, educational and psychosocial challenges to their development than their peers with healthy living parents. A cross-sectional survey was conducted, assessing the level and nature of abuse and neglect experienced by AIDS orphans in Conakry and N’Zérékoré, Guinea. Additionally, the degree of perceived social support in children whose parents were still alive and not perceived to be HIV positive, children orphaned by causes other than AIDS, and children orphaned by AIDS was explored. The results suggest that experiences of abuse and neglect are common in AIDS-orphaned children, and that adequate social support from family members is often lacking. However, social vulnerability was not limited to children orphaned due to AIDS. Scaled-up, non-discriminatory interventions to improve the psychosocial well-being of AIDS orphans and other vulnerable children are therefore urgently needed, and should be complemented with sound monitoring and evaluation of their effectiveness, scalability and affordability.

Published on November 19, 2010 by

Substance abuse in the Western Cape Province of South Africa: insights through mathematical modelling

In recent years there has been a dramatic increase in treatment demand for abuse of drugs including methamphetamine (MA) in the Western Cape Province (WCP) of South Africa. MA use has been linked to risky sexual behaviour and sexually transmitted infections including HIV. Thus, MA use has immense public health implications. It is against this background that a model was formulated to study the dynamics of treatment use for MA abuse in the WCP, with the aim of providing a predictive tool for the prevalence of drug use. The results of this study are presented in this article.