We assess here the potential effect of expanded HIV treatment for the prevention of AIDS-related deaths. We analyzed the available UNAIDS data to describe AIDS-related deaths, ART coverage and new HIV infections in 30 countries with the highest AIDS mortality burden and compared it with data from eight high-income countries. For illustrative purposes, we also explored the potential impact of reaching international treatment expansion targets in South Africa and Nigeria- two countries with the largest HIV epidemics, but with different trends of AIDS-related deaths over time – through the examination of four treatment expansion scenarios.
A new software tool that can simulate the spread of HIV and estimate the impact and cost-effectiveness of various prevention and treatment interventions.
At the 3rd Annual Congress of ISPOR South Africa, Wim Delva – senior researcher at SACEMA – gave a presentation on age-targeted early HIV treatment initiation. As reported earlier in the SACEMA Quarterly, universal, immediate antiretroviral treatment (ART) has the potential to reduce HIV incidence dramatically (1). However, this may not be feasible nor affordable Read More
One of the major obstacles to meeting the Millennium Development Goals is the HIV-associated epidemic. Of the estimated 9.3 million new TB cases that occurred worldwide in 2007, 1.37 million (14.8%) were associated with HIV. Sub-Saharan Africa has borne the burden of this co-epidemic. South Africa alone accounts for a staggering one in four of the world’s cases of HIV-associated TB. This article gives an answer to the question why traditional TB control strategies have failed; what other interventions could do; what the possible TB preventive impact of antiretroviral therapy could be and how ART could be optimally used.
The central theme of this first SACEMA Quarterly Epidemiological Update of 2010 is the rate of occurrence of new HIV infections – also known as HIV incidence. The issue is examined through three distinct perspectives: 1) Recent advances in measuring the HIV incidence in a population, and/or how it changes over time, 2) estimating the relative importance of various ‘modes of transmission’ in contributing to new cases of HIV infection, and 3) the use of antiretroviral treatment of infected individuals to curb their infectivity and hence reduce HIV incidence.
Behaviour change interventions have not brought about a sufficient reduction in HIV transmission. The question is whether anti-retroviral therapy (ART), used to effectively treat HIV patients, could also be used to stop transmission. This article discusses whether treatment-as-prevention is feasible, by determining the extent to which ART reduces the infectiousness of HIV-positive people. Furthermore, it looks at whether this is a realistic approach, by considering the levels of acceptance and compliance that might be achieved, the cost of the drugs, the rate of development of resistance, drug delivery and patient management.
In November two meetings took place in Geneva on the decision how, if at all, antiretroviral therapy could be used as an offensive weapon against the HIV pandemic – rather than simply in its current defensive role of keeping alive people who have generally already reached late stages of infection. This article reports on the discussions and most important outcomes of these meetings.
The Presidents Emergency Plan for AIDS Relief (PEPFAR) which was launched in 2003 as a 5-year, $15 billion program for HIV treatment, prevention and care, has been the most ambitious initiative to address the global HIV epidemic. Recently the effect of PEPFAR on HIV-related deaths, the number of people living with HIV, and HIV prevalence Read More