Published on September 14, 2016 by

Ending AIDS in South Africa: progress and prospects

World-wide South Africa has the largest epidemic of HIV and the biggest anti-retroviral programme. But reaching the UNAIDS 90-90-90 target by 2020 and ending AIDS by 2030 will require an expansion of surveillance and strengthening patient monitoring. Both are needed to monitor progress, identify and correct problems and to demonstrate success. Here we outline the current state of the epidemic and discuss important issues that should inform the National Strategic Plan to be launched on World AIDS Day in December.

Short item Published on September 14, 2016

Investigating inconsistencies between the reported and predicted lifetime number of sexual partners in Cape Town, South Africa.

Common indicators such as the number of new sexual partners in a given year and the lifetime number of sexual partners are used in several analyses to predict the risk of contracting HIV. However, are these indicators consistent?

Short item Published on September 14, 2016

Intimate partner violence and age disparity in Sub-Saharan Africa

Intimate partner violence (IPV) is a public health problem that has drawn considerable research attention over the last few decades. Studies that have looked at age disparity as a risk factor of IPV show conflicting results regarding the direction of the association. It is due to these conflicting results that we sought to investigate if having an older partner is protective against IPV, compared to having a partner of closer age, in Sub-Saharan Africa using data from Demographic Health Surveys.

Short item Published on September 14, 2016

Tsetse and trypanosomiasis modelling workshop

In the last week of June 2016, fifteen scientists converged on Stellenbosch for a week-long intensive workshop, hosted by SACEMA, aimed at sharing their knowledge of the problems and prospects associated with modelling the population dynamics of tsetse flies (Glossina spp) and the trypanosomes that they transmit in Africa to game animals, domestic livestock and humans.

Published on June 15, 2016 by

Future needs for characterising the care cascade

With the release of the WHO Consolidated Strategic Information Guidelines , countries are provided with a template, in the form of a depiction of the “Care Cascade”, permitting them to quantify the state of care as it currently stands. The Care Cascade begins by characterising all infected individuals in a population, before illustrating the cascading loss of patients at each stage of care between diagnosis and viral suppression. Countries are now beginning to produce estimates of their national cascades in order to evaluate the efficiency of current care programmes. This article discusses data issues related to cascade reporting and suggests ways to improve reporting.

Published on June 15, 2016 by

Pattern, determinants, and impact of HIV spending on care and treatment in 38 high-burden low- and middle-income countries

To fast-track the HIV response and end AIDS by 2030, the Joint United Nations Programme on HIV/AIDS (UNAIDS) called for 90-90-90 targets for 2020. Achieving these targets has resource implications – it will require increase in spending and efficient utilization of HIV funding and lead to savings by preventing illness, deaths, and new HIV infections. Thus, how countries decide to allocate and prioritize their HIV funding will directly impact whether end of AIDS is achieved. This article examines the pattern, source, determinants, and impact of HIV spending on care and treatment from 2009 to 2013 in 38 LMICs, which are home to 73% of PLHIV.

Published on June 15, 2016 by

High risk of reinfection TB in hyperendemic settings: Reasons and remedies.

It is known that in high TB incidence settings the rate of recurrent TB disease is much higher than the rate for first-time disease. It is not clear why the rate of reinfection disease can be elevated compared to the rate of primary disease. We set about attempting to estimate the actual values of the risk of reinfection and the rate of progress to disease for the high-incidence community of Ravensmead-Uitsig in Cape Town.

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.

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