The biennial International AIDS Society (IAS) Conference on HIV Science was held in Paris, France in July 2017. This article presents some of the highlights of the conference, including the roll of PrEP and the promise of long-acting injectable ARVs, as well as contributions of SACEMA staff in the areas of HIV and Hepatitis C, and HIV and cervical cancer. Basic, clinical, epidemiological and operational research on HIV and the HIV response must continue to be prioritised even while we strengthen our health systems and improve the implementation of existing interventions.
SACEMA’s 11th annual ‘Research Days’ meeting took place over four days 21 – 24 August 2017, in Stellenbosch. All SACEMA funded students and their supervisors were invited, together with some associates and collaborators. The meeting included training workshops, keynote talks, formal research presentations, student and supervisor forums, and a debate.
SACEMA researchers Alex Welte and Eduard Grebe have written a provocative general-audience reflection on the system of ‘peer review’ in academic publishing. They argue that pre-publication peer review is a not needed anymore and the focus should be on post-publication peer review.
: In the context of an implementation research project, aiming at better aligning targeted services with the general health services, we conducted cross-sectional surveys among a representative sample of female sex workers (FSWs) in four cities. We explored, through structured face-to-face interviews, where FSWs procure commodities and services for sexual and reproductive health. We compared service utilization across the four cities and assessed if it was significantly different.
Abstract: Twenty years ago, in 1997, I wrote the following piece reflecting on the Mothusimpilo project, an early attempt to understand and help to manage the epidemic of HIV in South Africa. I thought it might be interesting for you to look back on where we have come from.
Two months ago Lander Willem and I organized the first edition of the short course “Individual-based modelling in epidemiology: A practical introduction”. The feedback at the end of the course was overwhelmingly positive, which left us feeling empowered and encouraged to not leave it at this first edition. Participants of the next edition should expect an even more hands-on course, with more time to acquire skills in developing, exploring and fitting individual-based models.
This study clearly shows the diversity of sex workers (SWs) and their varying HIV treatment needs in the workplace and at home. Standard treatment guidelines could therefore fall short of their intention to reduce vulnerability to poor health outcomes if a non-differentiated approach to care is followed. Trained staff who are sensitised to the local medical, emotional and legal needs of SWs are able to create user friendly services that encourage these vulnerable women to utilise services.
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.
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.
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.