HIV

Short item Published on June 18, 2015

New Estimates of the Global Burden of HIV: UNAIDS and the Health Metrics Institute

UNAIDS has reported that the prevalence of people infected with HIV but who are not on ART, the incidence of HIV, and AIDS related mortality are falling. The Health Metrics Institute recently made their own, semi-independent, assessment of the trends in each of these indicators and reached similar conclusions with small differences arising from the use of somewhat different assumptions. Both analyses suggest that the world is on track to end AIDS by 2030, but this will depend on continued expansion of treatment at about the present rate together with supportive prevention efforts in Sub-Saharan Africa. Unfortunately, the data on which these analyses are based is weak in almost all places and better data on patient monitoring, follow-up and support, including drug procurement, supply and delivery, and better routing surveillance are needed.

Published on June 18, 2015 by

HIV and adolescents

The recent HSRC household survey reports that the HIV prevalence among adolescents and young people is declining. Although the decline is important, the focus needs to be on the fact that the reported HIV prevalence levels are still very high, together with alarmingly high levels of HIV incidence. Prevention methods have demonstrated effectiveness in reducing the risk of HIV acquisition among many of the most-at-risk populations. More research is needed, however, into how HIV is spread among the adolescent population and how to decrease this spread.

Published on March 17, 2015 by

Are HIV prevalence and incidence declines in sub-Saharan Africa driven by changes in sexual risk behaviour?

Individuals across Africa may have changed their sexual behaviour following the visibility of AIDS in the public sphere in the mid to late 1990s. Though each change in behaviour may have been small, the changes affected simultaneously different aspects of individual sexuality, and added up cumulatively into a moderate reduction in sexual behaviour at the individual level. In turn, this change in individual behaviour was translated into massive disruption of sexual networks at the population level. This made it difficult for HIV to propagate in the population leading to large declines in HIV incidence and prevalence.

Short item Published on March 17, 2015

Incidence of TB and HIV in prospectively followed household contacts of TB index patients in South Africa

Household contacts of active TB cases are at increased risk of TB infection and several studies have measured TB prevalence in this key population. The study described here not only measured TB prevalence, but also measured TB and HIV incidence in the household contacts of 729 TB index cases in the Matlosana sub-district in North West Province. We concluded that the efficacy of contact tracing for TB control purposes might be improved by a second intensified case finding visit and by providing preventive treatment against TB for both HIV-infected and HIV-seronegative household contacts of TB cases.

Published on September 16, 2014 by

Editorial: Using models to fight disease: HIV and Ebola

Currently we are faced with two major threats from viral diseases: Over the last 30 years HIV has spread across the world and continues to plague us. Over the last 3 months the hemorrhagic fever caused by the Ebola virus has spread across West Africa killing thousands of people. If we are to contain HIV in the long-run and Ebola, hopefully, in a much shorter time, this will depend on our ability to understand the nature of the threat and the strategies of the disease causing organisms.

Published on September 16, 2014 by

Challenges of Agent-based Modelling of HIV Transmission

Epidemiological models for describing how a disease spreads through a population have been extremely useful to reduce the number of individuals who get sick or even die from illness. Developing meaningful and useful models is not easy however. In this paper, we first motivate the use of agent-based modelling and secondly, we present common challenges associated with agent-based modelling (of HIV) and our approaches to dealing with them.

Published on September 16, 2014 by

The potential effects of changing HIV treatment policy on tuberculosis outcomes in South Africa: results from three tuberculosis-HIV transmission models

Expanding ART coverage to healthier HIV patients is widely regarded as a potential strategy for addressing the rampant TB epidemic in high HIV-TB burden settings. Estimating the population-level impact of ART expansion on TB disease has proven challenging. We set out to estimate the potential effects of changing HIV treatment policy on TB outcomes in South Africa, comparing the results of three independent TB models. This project was part of a broader effort to shed light on the consequences of HIV policy changes, through model comparison and consensus building, a process pioneered in the HIV modelling field by the HIV Modelling Consortium.

Published on September 16, 2014 by

How can mathematical modelling advance TB control in high HIV prevalence settings?

Existing approaches to TB control have been no more than partially successful in areas with high HIV prevalence. In the context of increasingly constrained resources, mathematical modelling can augment understanding and support policy for implementing strategies most likely to bring public health and economic benefits. Recognising the urgency of TB control in high HIV prevalence settings and the potential contributions of modelling, the TB Modelling and Analysis Consortium (TB MAC) convened its first meeting between empirical scientists, policy makers and mathematical modellers in September 2012 in Johannesburg. Here we present a summary of results from these discussions, as well as progress made in South Africa.

Short item Published on September 16, 2014

Study of laboratory tests to discern ‘recently’ from ‘non-recently’ acquired HIV infection opens new possibilities for HIV surveillance and clinical management of HIV

Robust tests for recent HIV infection (as opposed to just HIV infection) would substantially reduce the enormous challenges of estimating HIV incidence (the rate of occurrence of new infections). This article of SACEMA and the related Policy Brief provides the results of the first independent evaluation of five incidence assays conducted by the Consortium for the Evaluation and Performance of HIV Incidence Assays.

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