HIV prevention

Published on June 15, 2017 by

The role of cities in ending the AIDS epidemic

City leaders across the world are showing commitment and are providing political and technical leadership in dealing with local issues and barriers to delivering health and social services where they are needed. Cities are taking action, through their networks and by involving affected communities, to achieving the HIV Fast-Track targets by 2020. Ending the AIDS epidemic in cities will have profound, long-lasting benefits for urban communities and for countries and the global community.

Short item Published on March 15, 2017

Age-disparate relationships and HIV transmission: not as simple as it may seem

Interventions to curb age-disparate relationships (ADR) are ongoing in spite of conflicting evidence that ADR are a risk factor for HIV transmission. There is a real need to explore the prevalence of ADR and understand what they mean for HIV transmission. We must first understand and describe these relationships; second, establish a causal relationship with HIV. We recently published a paper that explores those objectives in a population of 1,922 adult men and women living in Likoma Island, Malawi.

Short item Published on March 15, 2017

Beyond risk compensation: Clusters of antiretroviral treatment users in sexual networks can modify the impact of ART on HIV incidence

Early initiation of antiretroviral therapy (ART) significantly improves the survival of people living with HIV (PLWH) and reduces HIV transmission to uninfected partners. Mathematical models suggest that treatment-as-prevention programmes could lead to HIV elimination. How the clinical efficacy of ART in preventing HIV transmission translates to real-life settings depends in large part on the capacity of HIV programmes to engage and retain PLWH. The effects of ART on HIV incidence may also depend on changes in sexual network dynamics during the course of ART scale-up which are discussed in this article.

Published on December 9, 2016 by

Monitoring progress towards ending AIDS in South Africa

This article is based on the presentation given by John Hargrove at the NRF Science for Society Lecture entitled Ending HIV/AIDS in South Africa held on 1 December 2016 in Stellenbosch. He argues that the proactive use of ART (Treatment as Prevention or TasP) provides a powerful weapon for combatting the HIV epidemic, and that we also have the tools for monitoring and evaluating the progress of that programme. Mathematical modelling has played an important role, both in suggesting appropriate interventions, and in developing new monitoring methods, but we are still in for a long journey.

Short item Published on December 9, 2016

Sexual debut – An analysis of the Birth to Twenty data

Despite the importance of youth sexual behaviour for sexual and reproductive health and the severity of the HIV/AIDS there is relatively little empirical research on factors affecting the age at sexual debut in South Africa. In my dissertation I used survival analysis techniques to identify significant predictors of early sexual debut in a South African context. The results may assist in devising strategies and action plans to be used to educate adolescents in making informed and safe decisions regarding sexual debut.

Published on September 14, 2016 by

Connecting the dots: network data and models in HIV epidemiology

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.

Short item Published on June 15, 2016

The impact and cost of Botswana’s progress toward achieving the 2020 UNAIDS 90-90-90 antiretroviral therapy and virological suppression goals

Botswana has made substantial progress towards meeting the UNAIDS 90-90-90 target by 2020 under which 90% of people living with HIV will know their status, 90% of these will be on anti-retroviral therapy (ART), and 90% of these will have viral loads below 400/µL. In this paper we use a previously published model for Botswana to assess the future impact of their HIV control programme on new HIV infections, AIDS related mortality and the costs of doing this. We show that while treatment will have a major impact on incidence and mortality and will lead to net cost savings, prevention will lead to further small reductions in incidence and mortality, but will entail significant cost increases.

Published on September 15, 2015 by

The effect of sexually transmitted co-infections on HIV viral load among individuals on antiretroviral therapy

Antiretroviral therapy (ART) markedly reduces the risk of sexual transmission of HIV. This inspired the idea of treatment as prevention (TasP) to reduce population HIV incidence, by reducing the infectiousness of HIV-infected individuals. However, increased infectiousness when treated individuals are co-infected with other sexually transmitted infections (STIs) could potentially undercut the effectiveness of TasP programs. As there is limited knowledge about the impact of STI co-infections on HIV shedding from individuals on ART, this study reviewed all published scientific evidence.

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