According to the President’s Emergency Plan for AIDS Relief (PEPFAR), an AIDS-free generation entails that first, no one will be born with the virus; second, that as people get older, they will be at a far lower risk of becoming infected than they are today; and third, that if they do acquire HIV, they will get treatment that keeps them healthy and prevents them from transmitting the virus to others. We argue that an AIDS-free generation is possible in Southern Africa, but not unless the high rates of incident infections in key populations are reduced.
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.
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.
SACEMA organised two courses on Joint Modelling of Longitudinal and Survival Data, and Updating Scientific Knowledge through Bayesian Learning.
A new software tool that can simulate the spread of HIV and estimate the impact and cost-effectiveness of various prevention and treatment interventions.
The contributions in this issue of the SACEMA Quarterly focus on different aspects related to TB and incidence of HIV. This editorial focuses on HIV treatment as prevention by presenting the MaxART project (Maximizing ART for Better Health and Zero New HIV Infections). This project pursues the dream of reaching all people in Swaziland who are in need of treatment with an ultimate goal of preparing the country for the possibility of ending the HIV epidemic. SACEMA is one of the members of the MaxART consortium and is involved in various modelling and analysis activities that are presented here.
Living in single-sex hostels, separated from their girlfriends, wives and children, and with few or no alternative to turn to, binge drinking and commercial or sex are common choices for recreation among mineworkers in Southern Africa. Binge drinking facilitates the acquisition and transmission of HIV and other sexually transmitted infections due to increased sexual risk behaviour. To explore the potential of preventing new HIV infections among mineworkers by reducing binge drinking in this population, a mathematical model was developed that aims to capture the causal associations between binge drinking, sexual risk behaviours and HIV incidence.
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.