SACEMA’s experience is that low competence and poor self-efficacy in the use of statistical software packages is a major obstacle to acquiring and expanding expertise in statistical analysis. It was therefore decided to increase our efforts to strengthen hands-on capacity and confidence in data management, exploration and visualisation, using the versatile, open-source package R. We plan to offer an intensive one-week course in June 2014 which will include computer practicals with participants’ own data. The course also offers an opportunity to conduct education research.
Eastern and southern Africa remains the region most affected by the HIV epidemic in the world and accounts for more than 50% of the global burden of HIV. Significant progress has been made in recent years in the response to the epidemic in the region: new HIV infections and AIDS deaths have fallen while prevention and treatment services for HIV have increased substantially. While several challenges still remain, there is renewed optimism that the elimination of HIV and AIDS is not an impossible goal.
Reliable mortality data are essential for planning health interventions, yet such data are often not available or reliable in developing countries, especially in sub-Saharan Africa. Health and socio-demographic surveillance sites, such as Agincourt in South Africa, are often the only way to assess and prospectively understand health trends at a population level, and thus have the potential to address this gap. This article summarises the main findings from my PhD in which advanced methods were applied to better understand the dynamics of age-specific mortality both in space and time, to identify age-specific mortality risk factors which have a high “impact” at a population level, and to relate inequalities in risk factor distributions to observed spatial mortality risk patterns.
The importance of concurrency (overlapping sexual partnerships in which sexual intercourse with one partner occurs between two acts of intercourse with another partner) in driving HIV transmission in hyperendemic settings remains controversial. A modelling study concluded that the role of concurrency in accelerating the spread of HIV is dramatically reduced by coital dilution (the reduction in frequency of sex acts per sexual partner, as a result of acquiring additional partners). We recently examined self-reported data on coital frequency and condom use during monogamous and concurrent relationship episodes from a survey in three communities with a high HIV prevalence. A key question in our analysis was if there is evidence for coital dilution and/or increased condom use during episodes of concurrency.
Using a catalytic model no significant reduction of HIV incidence was found despite increasing ART coverage.
All models are imperfect, but unless the model both accounts for the known biology of the disease and is challenged with data this might not be detected.
SACEMA organised two courses on Joint Modelling of Longitudinal and Survival Data, and Updating Scientific Knowledge through Bayesian Learning.