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.
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.
We conducted surveys of travellers and their movement patterns in Mali, Burkina Faso, Zambia and Tanzania. We found that women travelling with children are a consistent group of relevance to malaria transmission. Our study also highlighted youth workers as a key traveller group of relevance to parasite dispersal in Mali.
The objective of my thesis was to develop a novel, parameterised mechanistic mathematical model which describes the dynamics of parasite invasion during the initial stages of malarial infection.
Juliet Pulliam has recently taken over from Alex Welte as director of SACEMA. In this issue, she reflects on the challenges – and many exciting opportunities – ahead.
The World Health Organization’s most recent guideline for the treatment of HIV recommends ART for all individuals living with HIV. Although this new recommendation is gaining traction among wealthier countries, many countries have not yet adopted this guideline. Instead, those countries follow a strategy of providing ART only to people with low CD4+ T-cell counts, which was necessary early in the HIV epidemic, but it is unclear whether the use of CD4 counts was based on sound science and logic.
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.
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.
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?
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.