Journal articles: 'HIV infections – South Africa – Soshanguve'

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Laher, Fatima, Linda-Gail Bekker, Nigel Garrett, Erica M. Lazarus, and Glenda E. Gray. "Review of preventative HIV vaccine clinical trials in South Africa." Archives of Virology 165, no. 11 (August 14, 2020): 2439–52. http://dx.doi.org/10.1007/s00705-020-04777-2.

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AbstractNew HIV infections continue relentlessly in southern Africa, demonstrating the need for a vaccine to prevent HIV subtype C. In South Africa, the country with the highest number of new infections annually, HIV vaccine research has been ongoing since 2003 with collaborative public-private-philanthropic partnerships. So far, 21 clinical trials have been conducted in South Africa, investigating seven viral vectors, three DNA plasmids, four envelope proteins, five adjuvants and three monoclonal antibodies. Active vaccine candidates have spanned subtypes A, B, C, E and multi-subtype mosaic sequences. All were well tolerated. Four concepts were investigated for efficacy: rAd5-gag/pol/nef showed increased HIV acquisition in males, subtype C ALVAC/gp120/MF59 showed no preventative efficacy, and the trials for the VRC01 monoclonal antibody and Ad26.Mos4.HIV/subtype C gp140/ aluminum phosphate are ongoing. Future trials are planned with DNA/viral vector plus protein combinations in concert with pre-exposure prophylaxis, and sequential immunization studies with transmitted/founder HIV envelope to induce broadly neutralizing antibodies. Finally, passive immunization trials are underway to build on the experience with VRC01, including single and combination antibody trials with an antibody derived from a subtype-C-infected South African donor. Future consideration should be given to the evaluation of novel strategies, for example, inactivated-whole-virus vaccines.

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Paz Bailey, G., M. Sternberg, D. A. Lewis, and A. Puren. "Acute HIV Infections among Men with Genital Ulcer Disease in South Africa." Journal of Infectious Diseases 201, no. 12 (June 15, 2010): 1811–15. http://dx.doi.org/10.1086/652785.

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Kincaid, D. Lawrence, Stella Babalola, and Maria Elena Figueroa. "HIV Communication Programs, Condom Use at Sexual Debut, and HIV Infections Averted in South Africa, 2005." JAIDS Journal of Acquired Immune Deficiency Syndromes 66 (August 2014): S278—S284. http://dx.doi.org/10.1097/qai.0000000000000242.

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Sirunwa, Imisani Simon. "The Prevention of HIV Infections in South Africa Focusing on Attitude and Behaviour." TEXILA INTERNATIONAL JOURNAL OF MANAGEMENT 5, no. 2 (August 31, 2019): 19–24. http://dx.doi.org/10.21522/tijmg.2015.05.02.art003.

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Adler, David H., Melissa Wallace, Thola Bennie, Megan Mrubata, Beau Abar, Tracy L. Meiring, Anna-Lise Williamson, and Linda-Gail Bekker. "Cervical Dysplasia and High-Risk Human Papillomavirus Infections among HIV-Infected and HIV-Uninfected Adolescent Females in South Africa." Infectious Diseases in Obstetrics and Gynecology 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/498048.

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Background.HIV-infected adolescents may be at higher risk for high-grade cervical lesions than HIV-uninfected adolescents. The purpose of this study was to compare the prevalence of high-risk HPV (HR-HPV) infections and Pap smear abnormalities between these two groups.Methods.In this cross-sectional study, we compared the HPV DNA and Pap smear results between 35 HIV-infected and 50 HIV-uninfected adolescents in order to determine the prevalence of HR-HPV genotypes and cervical cytological abnormalities. Comparisons were made using Pearsonχ2and independent-samplest-tests analyses, and associations between demographic and behavioral characteristics and HPV infections were examined.Results.HIV-infected participants were more likely to be infected with any HPV (88.6% versus 48.0%;P<0.001) and with at least one HR-HPV (60.0% versus 24.0%;P=0.001), and to have multiple concurrent HPV infections (68.6% versus 22.0%;P<0.001). HPV 16 and 18 were relatively underrepresented among HR-HPV infections. Abnormal Pap test results were more common among HIV-infected participants (28.8% versus 12.0%;P=0.054). A history of smoking was associated with HR-HPV infection.Conclusions.HIV-infected adolescents have an increased risk of infection with HR-HPV and of Pap test abnormalities. The majority of HR-HPV infections among our participants would not be prevented by the currently available vaccinations against HPV.

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Williams, Brian G., and Eleanor Gouws. "The epidemiology of human immunodeficiency virus in South Africa." Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences 356, no. 1411 (July 29, 2001): 1077–86. http://dx.doi.org/10.1098/rstb.2001.0896.

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We review the epidemiology of human immunodeficiency virus (HIV) in South Africa where the prevalence of HIV infection is among the highest in the world. The epidemic reached South Africa relatively recently but the prevalence of infection has increased rapidly and there are significant differences among provinces. Although few 15–year–old people are infected the prevalence increases rapidly with age thereafter, especially among women. The prevalence of herpes simplex virus type 2 exceeds that of HIV and curable sexually transmitted infections are common. ‘Circular migration’ may help to explain the high rates and rapid spread of HIV in the region. The incidence of tuberculosis has increased dramatically as a result of the HIV epidemic. Antiretroviral therapy for the prevention of vertical transmission has been shown to be effective in local conditions but transmission through breast–feeding remains problematical. While some epidemiological models have been developed, much more needs to be done in this regard in order to plan, coordinate and evaluate an effective response to the epidemic. We conclude by discussing some of the research that is needed and steps that could be taken to reduce the continued spread of the infection.

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Garcia-Jardon, Mirta, Vivek G. Bhat, E. Blanco-Blanco, and Andrez Stepian. "Postmortem findings in HIV/AIDS patients in a tertiary care hospital in rural South Africa." Tropical Doctor 40, no. 2 (March 19, 2010): 81–84. http://dx.doi.org/10.1258/td.2010.090465.

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South Africa has the largest number of people living with HIV/AIDS, and various associated infectious and noninfectious conditions contribute towards mortality. The objective of this study was to determine the important post-mortem findings in HIV-infected individuals in a high HIV burden rural area in South Africa. The patient population included HIV patients who died at the tertiary care hospital, from 2000–2008. Autopsies were performed according to standard protocols and diagnoses were made with additional laboratory investigations wherever required. A total of 86 patients were autopsied (30 males, 56 females). The major postmortem findings were related to infections, with 38% of the patients having had some form of tuberculosis, followed by pyogenic infections – pneumonias (21.5%), meningitis (10.1%) and septicemias (5.1%). Other important infections included opportunistic fungi like cryptococcosis (7.6%) and pneumocystis pneumonia (8.9%). Among the noninfectious conditions, the findings seen were predominantly related to liver (10.1%) and cardiac involvement (10.1%).

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Korenromp, Eline L., Anna Bershteyn, Edina Mudimu, Renay Weiner, Collen Bonecwe, Dayanund Loykissoonlal, Clarence Manuhwa, et al. "The impact of the program for medical male circumcision on HIV in South Africa: analysis using three epidemiological models." Gates Open Research 5 (January 25, 2021): 15. http://dx.doi.org/10.12688/gatesopenres.13220.1.

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Background: South Africa began offering medical male circumcision (MMC) in 2010. We evaluated the current and future impact of this program to see if it is effective in preventing new HIV infections. Methods: The Thembisa, Goals and Epidemiological Modeling Software (EMOD) HIV transmission models were calibrated to South Africa’s HIV epidemic, fitting to household survey data on HIV prevalence, risk behaviors, and proportions of men circumcised, and to programmatic data on intervention roll-out including program-reported MMCs over 2009-2017. We compared the actual program accomplishments through 2017 and program targets through 2021 with a counterfactual scenario of no MMC program. Results: The MMC program averted 71,000-83,000 new HIV infections from 2010 to 2017. The future benefit of the circumcision already conducted will grow to 496,000-518,000 infections (6-7% of all new infections) by 2030. If program targets are met by 2021 the benefits will increase to 723,000-760,000 infections averted by 2030. The cost would be $1,070-1,220 per infection averted relative to no MMC. The savings from averted treatment needs would become larger than the costs of the MMC program around 2034-2039. In the Thembisa model, when modelling South Africa’s 9 provinces individually, the 9-provinces-aggregate results were similar to those of the single national model. Across provinces, projected long-term impacts were largest in Free State, KwaZulu-Natal and Mpumalanga (23-27% reduction over 2017-2030), reflecting these provinces’ greater MMC scale-up. Conclusions: MMC has already had a modest impact on HIV incidence in South Africa and can substantially impact South Africa’s HIV epidemic in the coming years.

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Frohlich, J. A., Q. Abdool Karim, M. M. Mashego, A. W. Sturm, and S. S. Abdool Karim. "Opportunities for treating sexually transmitted infections and reducing HIV risk in rural South Africa." Journal of Advanced Nursing 60, no. 4 (November 2007): 377–83. http://dx.doi.org/10.1111/j.1365-2648.2007.04405.x.

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Dunkle, K. L., M. E. Beksinska, V. H. Rees, R. C. Ballard, Ye Htun, and M. L. Wilson. "Risk factors for HIV infection among sex workers in Johannesburg, South Africa." International Journal of STD & AIDS 16, no. 3 (March 1, 2005): 256–61. http://dx.doi.org/10.1258/0956462053420220.

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Our objective was to determine the prevalence and risk factors for HIV infection among female sex workers in Johannesburg, South Africa. A cross-sectional survey of female sex workers was conducted using interviewer-administered questionnaires. Prevalent sexually transmitted infections including HIV were evaluated through standard laboratory testing. HIV infection was identified in 137 (46.4%) of 295 subjects tested. Increasing frequency of condom use was significantly negatively associated with HIV infection (odds ratio [OR] for moderate use = 0.21; 95% confidence interval [CI]: [0.09, 0.50]; OR for high use = 0.14; 95% CI: [0.06, 0.34]). Sex workers aged ≥29 years reported significantly different patterns of behaviour than younger workers. Among women aged ≥29, a negative association with HIV infection (OR = 0.16; 95% CI: [0.07, 0.38]) was found, but only among those not infected with Neisseria gonorrhoeae. Older women in the Johannesburg sex industry may have adaptive behavioural strategies besides condom usage which reduce their risk of acquiring HIV. However, older sex workers with gonorrhoea constitute a high-risk subgroup.

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Naicker, Previn, and Yasien Sayed. "Non-B HIV-1 subtypes in sub-Saharan Africa: impact of subtype on protease inhibitor efficacy." Biological Chemistry 395, no. 10 (October 1, 2014): 1151–61. http://dx.doi.org/10.1515/hsz-2014-0162.

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Abstract In 2012, 25 million people [71% of global human immunodeficiency virus (HIV) infection] were estimated to be living with HIV in sub-Saharan Africa. Of these, approximately 1.6 million were new infections and 1.2 million deaths occurred. South Africa alone accounted for 31% of HIV/acquired immunodeficiency syndrome (AIDS) deaths in sub-Saharan Africa. This disturbing statistic indicates that South Africa remains the epicenter of the HIV/AIDS pandemic, compounded by the fact that only 36% of HIV-positive patients in South Africa have access to antiretroviral (ARV) treatment. Drug resistance mutations have emerged, and current ARVs show reduced efficacy against non-B subtypes. In addition, several recent studies have shown an increased prevalence of non-B African HIV strains in the Americas and Europe. Therefore, the use of ARVs in a non-B HIV-1 subtype context requires further investigation. HIV-1 subtype C protease, found largely in sub-Saharan Africa, has been under-investigated when compared with the subtype B protease, which predominates in North America and Europe. This review, therefore, focuses on HIV-1 proteases from B and C subtypes.

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Mudimu, Edinah, Kathryn Peebles, Zindoga Mukandavire, Emily Nightingale, Monisha Sharma, Graham F. Medley, Daniel J. Klein, Katharine Kripke, and Anna Bershteyn. "Individual and community-level benefits of PrEP in western Kenya and South Africa: Implications for population prioritization of PrEP provision." PLOS ONE 15, no. 12 (December 31, 2020): e0244761. http://dx.doi.org/10.1371/journal.pone.0244761.

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Background Pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV and has the potential to significantly impact the HIV epidemic. Given limited resources for HIV prevention, identifying PrEP provision strategies that maximize impact is critical. Methods We used a stochastic individual-based network model to evaluate the direct (infections prevented among PrEP users) and indirect (infections prevented among non-PrEP users as a result of PrEP) benefits of PrEP, the person-years of PrEP required to prevent one HIV infection, and the community-level impact of providing PrEP to populations defined by gender and age in western Kenya and South Africa. We examined sensitivity of results to scale-up of antiretroviral therapy (ART) and voluntary medical male circumcision (VMMC) by comparing two scenarios: maintaining current coverage (“status quo”) and rapid scale-up to meet programmatic targets (“fast-track”). Results The community-level impact of PrEP was greatest among women aged 15–24 due to high incidence, while PrEP use among men aged 15–24 yielded the highest proportion of indirect infections prevented in the community. These indirect infections prevented continue to increase over time (western Kenya: 0.4–5.5 (status quo); 0.4–4.9 (fast-track); South Africa: 0.5–1.8 (status quo); 0.5–3.0 (fast-track)) relative to direct infections prevented among PrEP users. The number of person-years of PrEP needed to prevent one HIV infection was lower (59 western Kenya and 69 in South Africa in the status quo scenario; 201 western Kenya and 87 in South Africa in the fast-track scenario) when PrEP was provided only to women compared with only to men over time horizons of up to 5 years, as the indirect benefits of providing PrEP to men accrue in later years. Conclusions Providing PrEP to women aged 15–24 prevents the greatest number of HIV infections per person-year of PrEP, but PrEP provision for young men also provides indirect benefits to women and to the community overall. This finding supports existing policies that prioritize PrEP use for young women, while also illuminating the community-level benefits of PrEP availability for men when resources permit.

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Wium, Lizemarie, Valerie Vannevel, and Salome Bothma. "Obstetric medical care and training in South Africa." Obstetric Medicine 12, no. 1 (July 20, 2018): 27–30. http://dx.doi.org/10.1177/1753495x18783610.

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Obstetric medicine as a speciality is yet to be developed in South Africa. South Africa is regarded as a developing country. The burden of HIV and metabolic syndrome creates a need for advanced maternal care. An increase has been noted in hypertension and gestational diabetes due to increasing maternal age and increasing prevalence of obesity. The South African National Committee on Confidential Enquiry into Maternal Deaths’ 2015 Saving Mothers Report identified non-pregnancy-related infections as the leading cause of maternal deaths. Obstetric medicine care includes pre-conception, antepartum and postpartum care. This article aims to highlight the importance of obstetric medicine, even in a resource-poor setting. The current internal medicine and obstetrics and gynaecology training is discussed and emphasis is placed on the opportunity to create an obstetric medicine programme.

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Lewis, David. "Detection and management of acute HIV infections in patients with sexually transmitted infections: a window of opportunity for HIV prevention within South Africa?" Southern African Journal of Epidemiology and Infection 27, no. 4 (January 2012): 149–55. http://dx.doi.org/10.1080/10158782.2012.11441502.

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Ganesh, Shayhana, Renitha Rampersad, and Nirmala Dorasamy. "A Review of Quality Management Systems in South African HIV-AIDS Programmes: A Pre-Requisite for Sustainable Health Delivery." Journal of Economics and Behavioral Studies 9, no. 1(J) (March 12, 2017): 135–40. http://dx.doi.org/10.22610/jebs.v9i1(j).1564.

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The global commitment to end HIV-AIDS is a bold one; requiring a multi-sectoral response strongly embedded within effective HIV-AIDS prevention efforts, patient advocacy and effective healthcare programme delivery. UNAIDS estimates that, of the 36.7 million individuals infected with HIV-AIDS globally, 19.1 million reside in South Africa (UNAIDS Gap report, 2016).In addition, approximately 2.1 million new HIV infections occurred in 2015 with almost 960 000 of those occurring in South Africa signalling that the rates of infections are not dropping as expected (UNAIDS Gap report, 2016). Given the unrelenting nature of this disease burden, even greater efforts are now required to turn the tide on HIV-AIDS globally, but more so in South Africa. These efforts entail more effective HIV-AIDS service delivery with combination prevention modalities, access to HIV-AIDS treatment and care, harm reduction of HIV-AIDS stigma and discrimination together with HIV-AIDS education, awareness and advocacy. Enhancing HIV-AIDS service delivery requires strong commitment with implementation of quality management systems in programme service delivery resulting in sustainable, effective and well run HIV-AIDS programmes. Quality management systems in HIV-AIDS programmes allow programmes to successfully meet their objectives thus allowing optimal patient care through effective and efficient means. To date there has been minimal implementation of quality systems in healthcare especially in South Africa. The use of health quality tools and systems in HIV-AIDS programmes locally and globally will allow for efficient and cost effective benefits for the optimal wellbeing of all those affected and infected by HIV-AIDS. This article reviews available data on the prevalence of quality management systems in HIV-AIDS healthcare and identifies gaps and smart practises towards recommendations for comprehensive global HIV-AIDS standards development.

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Ganesh, Shayhana, Renitha Rampersad, and Nirmala Dorasamy. "A Review of Quality Management Systems in South African HIV-AIDS Programmes: A Pre-Requisite for Sustainable Health Delivery." Journal of Economics and Behavioral Studies 9, no. 1 (March 12, 2017): 135. http://dx.doi.org/10.22610/jebs.v9i1.1564.

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The global commitment to end HIV-AIDS is a bold one; requiring a multi-sectoral response strongly embedded within effective HIV-AIDS prevention efforts, patient advocacy and effective healthcare programme delivery. UNAIDS estimates that, of the 36.7 million individuals infected with HIV-AIDS globally, 19.1 million reside in South Africa (UNAIDS Gap report, 2016).In addition, approximately 2.1 million new HIV infections occurred in 2015 with almost 960 000 of those occurring in South Africa signalling that the rates of infections are not dropping as expected (UNAIDS Gap report, 2016). Given the unrelenting nature of this disease burden, even greater efforts are now required to turn the tide on HIV-AIDS globally, but more so in South Africa. These efforts entail more effective HIV-AIDS service delivery with combination prevention modalities, access to HIV-AIDS treatment and care, harm reduction of HIV-AIDS stigma and discrimination together with HIV-AIDS education, awareness and advocacy. Enhancing HIV-AIDS service delivery requires strong commitment with implementation of quality management systems in programme service delivery resulting in sustainable, effective and well run HIV-AIDS programmes. Quality management systems in HIV-AIDS programmes allow programmes to successfully meet their objectives thus allowing optimal patient care through effective and efficient means. To date there has been minimal implementation of quality systems in healthcare especially in South Africa. The use of health quality tools and systems in HIV-AIDS programmes locally and globally will allow for efficient and cost effective benefits for the optimal wellbeing of all those affected and infected by HIV-AIDS. This article reviews available data on the prevalence of quality management systems in HIV-AIDS healthcare and identifies gaps and smart practises towards recommendations for comprehensive global HIV-AIDS standards development.

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Mitha, Mohammed, Preneshni Naicker, and Prakash Mahida. "Disseminated Cryptococcosis in an HIV-negative patient in South Africa: the elusive differential diagnosis." Journal of Infection in Developing Countries 4, no. 08 (May 4, 2010): 526–29. http://dx.doi.org/10.3855/jidc.813.

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The presence of an opportunistic infection in a patient in sub-Saharan Africa is assumed to be due to underlying immunosuppression from human immunodeficiency virus (HIV) infection. The presence of disseminated cryptococcosis in a non-HIV-infected patient is interesting as it is unique in our setting because the majority of infections are found in HIV-infected individuals. The protean manifestations of the disease and its predilection for immunosuppressed patients make cryptococcosis a challenging and elusive disease to diagnose in HIV-negative patients in our setting, especially due to limited resources. We present a case of disseminated cryptococcosis in an immunocompetent patient and discuss diagnostic and therapeutic features in this subset of patients.

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CONNOLLY, CATHERINE A., GITA RAMJEE, ADRIAAN W. STURM, and SALIM S. ABDOOL KARIM. "Incidence of Sexually Transmitted Infections Among HIV-Positive Sex Workers in KwaZulu-Natal, South Africa." Sexually Transmitted Diseases 29, no. 11 (November 2002): 721–24. http://dx.doi.org/10.1097/00007435-200211000-00017.

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Archary, Moherndran, Hugh Adler, Philip La Russa, Prasha Mahabeer, and Raziya A. Bobat. "Bacterial infections in HIV-infected children admitted with severe acute malnutrition in Durban, South Africa." Paediatrics and International Child Health 37, no. 1 (July 4, 2016): 6–13. http://dx.doi.org/10.1080/20469047.2016.1198561.

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Ajoge, Hannah O., Stephen O. Olonitola, and David R. Smith. "Soil-transmitted helminths are a serious but understudied health concern in South Africa, requiring immediate attention from the scientific community." F1000Research 3 (September 11, 2014): 209. http://dx.doi.org/10.12688/f1000research.4812.2.

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Parasitic roundworms and flatworms, defined broadly as helminths, are estimated to infect over 1 billion people worldwide, and are particularly prevalent in developing, resource-strained communities. The consequences of these infections are immense and wide reaching, resulting in massive reductions in local and global economic productivity and contributing to millions of deaths per year. Helminth diseases can also reduce vaccine efficacy and heighten morbidity rates of other serious illnesses, including tuberculosis and HIV/AIDS. Here, we argue that South Africa, which has one the highest rates of both HIV/AIDS and helminth infections on earth, needs to allocate more energy and resources into studying soil-transmitted helminths. Using PubMed and GenBank statistics, we show that the current South African research output on soil-transmitted helminths pales in comparison to that on HIV and tuberculosis. Basic research on helminth biology as well as on the social and environmental effects associated with infections could greatly reduce the burden of HIV/AIDS, tuberculosis, and other major illnesses in South Africa and beyond. The onus is on scientists, funding agencies, and governing bodies to channel efforts into studies on soil-transmitted helminths.

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Chikandiwa, Admire, Pedro T. Pisa, Matthew F. Chersich, Etienne E. Muller, Philippe Mayaud, and Sinead Delany-Moretlwe. "Oropharyngeal HPV infection: prevalence and sampling methods among HIV-infected men in South Africa." International Journal of STD & AIDS 29, no. 8 (February 22, 2018): 776–80. http://dx.doi.org/10.1177/0956462418755882.

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Worldwide, 96,000 cases of oropharyngeal cancer (OPC) occurred in 2012. Human papillomavirus (HPV) is a risk factor for OPC. Data on oropharyngeal HPV infection are limited. There is no consensus on the best sampling method for detecting the infection. We describe the prevalence of oropharyngeal HPV infection among HIV-infected men and compare the performance of oral rinses and swabs in detecting oropharyngeal HPV infection. Paired oral rinses and swabs for 181 men were tested for HPV DNA using the Roche Linear Array. Performance was determined by the number of infections detected and the percentage of samples with adequate DNA extraction. Agreement between sampling methods was assessed by the kappa statistic. Prevalence of oropharyngeal HPV infection with rinse samples was 1.8% (three infections) and 0.6% (one infection) with swabs (p = 0.06). Adequate cellular DNA extraction was more likely with rinse (93.4%) than swab samples (89.0%, p = 0.05). There was moderate agreement between the methods (kappa = 0.49). The prevalence of oropharyngeal HPV DNA infection among this predominantly heterosexual sample of men living with HIV was low and consistent with the infrequent oral sex practices. Oral rinse performed better than oral swab in detecting oropharyngeal HPV DNA infection and might contribute to screening for OPCs.

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Mkhize, B. T., M. Mabaso, T. Mamba, C. E. Napier, and Z. L. Mkhize-Kwitshana. "The Interaction between HIV and Intestinal Helminth Parasites Coinfection with Nutrition among Adults in KwaZulu-Natal, South Africa." BioMed Research International 2017 (2017): 1–12. http://dx.doi.org/10.1155/2017/9059523.

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In South Africa few studies have examined the effects of the overlap of HIV and helminth infections on nutritional status. This cross-sectional study investigated the interaction between HIV and intestinal helminths coinfection with nutritional status among KwaZulu-Natal adults. Participants were recruited from a comprehensive primary health care clinic and stratified based on their HIV, stool parasitology, IgE, and IgG4 results into four groups: the uninfected, HIV infected, helminth infected, and HIV-helminth coinfected groups. The nutritional status was assessed using body mass index, 24-hour food recall, micro-, and macronutrient biochemical markers. Univariate and multivariate multinomial probit regression models were used to assess nutritional factors associated with singly and dually infected groups using the uninfected group as a reference category. Biochemically, the HIV-helminth coinfected group was associated with a significantly higher total protein, higher percentage of transferrin saturation, and significantly lower ferritin. There was no significant association between single or dual infections with HIV and helminths with micro- and macronutrient deficiency; however general obesity and low micronutrient intake patterns, which may indicate a general predisposition to micronutrient and protein-energy deficiency, were observed and may need further investigations.

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Mosepele, Mosepele, Cecilia Kanyama, David Meya, Fiona Cresswell, Timothee Chammard, Henry Mwandumba, Graeme Meintjes, Godfrey S. Mfinanga, Chiratidzo Ndhlovu, and Joseph Jarvis. "PO 8719 INTRODUCING A NEW AFRICA MENINGITIS NETWORK – A NORTH-SOUTH COLLABORATION." BMJ Global Health 4, Suppl 3 (April 2019): A63.1—A63. http://dx.doi.org/10.1136/bmjgh-2019-edc.165.

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BackgroundCentral nervous system infections, including meningitis, continue to cause significant morbidity in Africa. HIV has contributed to the epidemiology of CNS infections in this setting. Notable advances in the study of CNS infections by several groups have demonstrated the utility of new diagnostic strategies and impact of novel treatment strategies. However, efforts to coordinate meningitis research in Africa, and between Africa and the rest of the world remain very limited.MethodsIn a bid to promote a coordinated study of CNS infections across Africa, and in collaboration with other meningitis groups globally, the researchers of the AMBITION study (High Dose Ambisome on a Fluconazole Backbone for Cryptococcal Meningitis Induction Therapy in Sub-saharan Africa: A Randomised Controlled Non-inferiority Trial) are leveraging the EDCTP support for the AMBITION trial to set up an Africa Meningitis Trials Network.ResultsThe Africa Meningitis Trials Network (AMNET) was launched in Malawi in early 2018. Main achievements since the launch of the network, include an internal review of meningitis research across network sites and launch of the network website. The network also has two study protocols pending ethics review at all sites. These studies will provide much needed information on resources available for meningitis care, research and provide a baseline epidemiology of meningitis in Africa.ConclusionAMNET provides a rare opportunity for investigators interested in meningitis research to leverage the ongoing AMBITION trial to conduct Africa-wide preliminary research on meningitis. The network is recruiting additional members in Africa and globally to collaborate on meningitis research, and also apply for research funding to support meningitis work. Anyone interested in knowing more about the network should contact the AMNET communications officer, Ms Phum’lani Machao, phumlani.machao@gmail.com

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Rehle, Thomas M., Timothy B. Hallett, Olive Shisana, Victoria Pillay-van Wyk, Khangelani Zuma, Henri Carrara, and Sean Jooste. "A Decline in New HIV Infections in South Africa: Estimating HIV Incidence from Three National HIV Surveys in 2002, 2005 and 2008." PLoS ONE 5, no. 6 (June 14, 2010): e11094. http://dx.doi.org/10.1371/journal.pone.0011094.

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Akullian, Adam, Alain Vandormael, Joel C. Miller, Anna Bershteyn, Edward Wenger, Diego Cuadros, Dickman Gareta, Till Bärnighausen, Kobus Herbst, and Frank Tanser. "Large age shifts in HIV-1 incidence patterns in KwaZulu-Natal, South Africa." Proceedings of the National Academy of Sciences 118, no. 28 (July 9, 2021): e2013164118. http://dx.doi.org/10.1073/pnas.2013164118.

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Recent declines in adult HIV-1 incidence have followed the large-scale expansion of antiretroviral therapy and primary HIV prevention across high-burden communities of sub-Saharan Africa. Mathematical modeling suggests that HIV risk will decline disproportionately in younger adult age-groups as interventions scale, concentrating new HIV infections in those >age 25 over time. Yet, no empirical data exist to support these projections. We conducted a population-based cohort study over a 16-y period (2004 to 2019), spanning the early scale-up of antiretroviral therapy and voluntary medical male circumcision, to estimate changes in the age distribution of HIV incidence in a hyperepidemic region of KwaZulu-Natal, South Africa, where adult HIV incidence has recently declined. Median age of HIV seroconversion increased by 5.5 y in men and 3.0 y in women, and the age of peak HIV incidence increased by 5.0 y in men and 2.0 y in women. Incidence declined disproportionately among young men (64% in men 15 to 19, 68% in men 20 to 24, and 46% in men 25 to 29) and young women (44% in women 15 to 19, 24% in women 20 to 24) comparing periods pre- versus post-universal test and treat. Incidence was stable (<20% change) in women aged 30 to 39 and men aged 30 to 34. Age shifts in incidence occurred after 2012 and were observed earlier in men than in women. These results provide direct epidemiological evidence of the changing demographics of HIV risk in sub-Saharan Africa in the era of large-scale treatment and prevention. More attention is needed to address lagging incidence decline among older individuals.

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ZUMA, K., M. N. LURIE, B. G. WILLIAMS, D. MKAYA-MWAMBURI, G. P. GARNETT, and A. W. STURM. "Risk factors of sexually transmitted infections among migrant and non-migrant sexual partnerships from rural South Africa." Epidemiology and Infection 133, no. 3 (February 2, 2005): 421–28. http://dx.doi.org/10.1017/s0950268804003607.

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In October 1998, cohorts of circular migrant men and their non-migrant sexual partners, and non-migrant men and their non-migrant sexual partners from rural South Africa were recruited and followed-up every 4 months until October 2001. At each visit, information on socio-demographic, sexual behaviour, sexually transmitted infections (STIs) and HIV was collected. In total, 553 individuals aged between 18 and 69 years were recruited. A man and his sexual partner(s) form a sexual partnership. Migration status, age, marital status, age at sexual debut, recent sexual partners and HIV status were found to be important determinants of STI. The risk of STI varies (σ2=1·45, P<0·001) significantly across sexual partnerships even after controlling for important determinants. The variance implies substantial correlation (0·59) between members of the same sexual partnership. Ignoring this correlation leads to incorrect inference. Migration contributes significantly to the spread of STIs. Community interventions of HIV/STI should target co-transmitter sexual partnerships rather than high-risk individuals.

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Beksinska, Mags E., Jennifer A. Smit, and Joanne E. Mantell. "Progress and challenges to male and female condom use in South Africa." Sexual Health 9, no. 1 (2012): 51. http://dx.doi.org/10.1071/sh11011.

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South Africa has responded to the sexually transmissible infection and HIV epidemic with a rapid expansion of its national-level public sector condom program. Male condoms are available widely at no cost in the public sector, with expanded access via social marketing and the private sector. The female condom program is one of the largest and best established globally. National surveys show progressive increases in rates of condom use at last sex. However, inconsistent and incorrect condom use and the likelihood that condoms are discontinued in longer-term partnerships are some of the challenges impeding the condom program’s successes in the fight against sexually transmissible infections and HIV. This article reviews the current condom program, related guidelines and policies, and the existing data on male and female condom use, including distribution and uptake. We discuss the main challenges to condom use, including both user and service-related issues and finally how these challenges could be addressed.

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Matseke, Gladys, Karl Peltzer, Julia Louw, Pamela Naidoo, Gugu Mchunu, and Bomkazi Tutshana. "Inconsistent Condom Use among Public Primary Care Patients with Tuberculosis in South Africa." Scientific World Journal 2012 (2012): 1–6. http://dx.doi.org/10.1100/2012/501807.

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The high rate of HIV infections among tuberculosis (TB) patients in South Africa calls for urgent HIV reduction interventions in this subpopulation. While correct and consistent condom use is one of the effective means of HIV prevention among sexually active people, there is insufficient research on condom use among TB patients in South Africa. The aim of this paper was to determine the prevalence of inconsistent condom use among public primary care TB patients and its associated factors using a sample of 4900 TB patients from a cross-sectional survey in three health districts in South Africa. Results indicated that when asked about their consistency of condom use in the past 3 months, 63.5% of the participants reported that they did not always use condoms. In the multivariable analysis, being married (OR=1.66; 95% CI 1.25–2.20) or cohabitating or separated, divorced, or widowed (OR=3.67; 1.85–7.29), lower educational level (OR=0.66; 0.46–0.94), greater poverty (OR=1.60; 1.25–2.20), not having HIV status disclosed (OR=0.34; 0.25–0.48), sexual partner on antiretroviral treatment (OR=0.38; 0.23–0.60), and partner alcohol use before sex (OR=1.56; 1.30–1.90) were significantly associated with inconsistent condom use in the past 3 months. The low proportion of consistent condom use among TB patients needs to be improved.

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Samie, Amidou, Rhulani Patricia Maluleke, Nicoline Tanih, and Ali ElBakri. "Molecular epidemiology of Microsporidia among HIV-positive and HIV-negative patients in the Limpopo province, South Africa." Journal of Infection in Developing Countries 15, no. 05 (May 31, 2021): 710–18. http://dx.doi.org/10.3855/jidc.12988.

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Introduction: Human microsporidiosis represents an important and rapidly emerging opportunistic disease. The present study investigated the prevalence of microsporidia among HIV positive and HIV negative patients with or without diarrhoea in Vhembe and Mopani Districts in the Limpopo Province. Methodology: A total of 170 stool samples were collected from these patients and microsporidia species was detected using a Real-Time PCR targeting a conserved region of the small ribosomal subunit rRNA (SSU-rRNA) gene of Enterocytozoon bieneusi, Encephalitozoon intestinalis, Encephalitozoon hellem, and Encephalitozoon cuniculi. Results: Fifty six (32.9%) were positive for microsporidia. The prevalence was higher in HIV negative patients (36.6%) while 24.1% of patients who were HIV positive had microsporidia. Microsporidia was more common among patients aged between 1 and 10 years (52.6%). However among the HIV positive patients, microsporidia prevalence was higher among those that were not taking antiretrovirals (ARVs) compared to those who were on ARVs, (36.6%) and (24.1%), respectively. Microsporidia was also noted to be significantly associated with diarrheal and stomach pains; p = 0.02 and p = 0.048, respectively. Furthermore, microsporidia infections was more prevalent among patients who had animals at home (p = 0.037). Conclusions: Study has shown a high prevalence of microsporidia among patients attending primary health centers in the Mopani District for the first time. Prevalence of microsporidia was higher among HIV negative and HIV positive patients who were not on ARV treatment. Keeping animals in the household appeared to be a risk of getting infected with microsporidia. Further studies are needed to determine the genetic characteristics of these organisms in the study population.

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Chonco, F. M., and S. Rangiah. "Susceptibility to hepatitis B infection, hepatitis B/HIV co-infections and hepatitis B immunity in HIV-positive patients starting HAART in Durban, South Africa." South African Family Practice 61, no. 2 (April 29, 2019): 51. http://dx.doi.org/10.4102/safp.v61i2.5004.

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Background: HIV/HBV co-infection remains a global threat to HIV management despite the available effective hepatitis B vaccine and hepatitis B covering antiretroviral therapy. Many studies done in South Africa and internationally showed high prevalence of HIV/hepatitis B co-infection, which mandated routine screening for both infections before initiating HAART. Fewer studies have highlighted the prevalence of hepatitis B susceptibility in the general population starting HAART and most of them were limited to children and high-risk groups. The aim of this study was to demonstrate the extent of hepatitis B susceptibility, hepatitis B/HIV co-infections and hepatitis B immunity in general HIV-infected patients.Method: This was a retrospective review of 1 066 randomly sampled files of patients initiated on HAART between January 2012 and December 2014 at two Durban hospitals. Data collection included demographic characteristic, CD4 counts and hepatitis B serology. Data were analysed for the prevalence of hepatitis B susceptibility, HIV/HBV co-infection and hepatitis B immunity, while correlations between age, CD4 count and these three groups were demonstrated. Statistical analysis was performed using SAS version 9.3.Results: Total prevalence of HBV susceptibility was 69.7%, HBV immunity was 26.9% and true chronic HIV/HBV co-infection was 3.4%, while HBVsAg positivity accounted for 8.4% of the participants. Adults were more susceptible to HBV than children, with a median age of 36 years. Stratified for age, children were more immune (90%) to HBV than adults.Conclusion: This study demonstrated a significantly high number of HIV-infected persons who were susceptible to hepatitis B infection in Durban, South Africa, where both HIV and HBV are endemic, co-infection is high, and safe and effective HBV vaccine is available. Hepatitis B vaccination of the hepatitis B susceptible patients initiating HAART in South Africa is recommended to prevent further HIV/HBV co-infection.

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Machimana, Eugene Gabriel, Phillip Nhlanhla, Petronella Nondumiso Nompilo Machimana, and Martin Chukwudi Ekeh. "HIV-Infections in Male Youths: Risks Associated with Alcohol Misuse." Open Journal for Anthropological Studies 5, no. 1 (May 6, 2021): 13–28. http://dx.doi.org/10.32591/coas.ojas.0501.02013m.

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The purpose of the study was to explore the influence of alcohol misuse in HIV-infection at the Health and Welfare Organisation in South Africa. There is an association between alcohol misuse and HIV transmission. Male youths may lack understanding of the effects of alcohol on their sexual behavior when under the influence of alcohol. This makes male youths vulnerable to HIV infection. Qualitative methodology was used for an in-depth understanding of the phenomenon under investigation. The findings indicate that many male youths are aware of HIV-preventative methods, but their behavior is not always in line with what they know. Therefore, we recommend that male youths should be taught about the risk of HIV infection associated with alcohol misuse in various places such as schools and taverns. HIV/AIDS education should emphasize practical intervention strategies. Condom use should not be neglected in favor of newer preventative strategies such as male circumcision and pre-exposure prophylaxis.

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Kalichman, Seth C., Leickness C. Simbayi, Demetria Cain, and Sean Jooste. "Condom failure among men receiving sexually transmissible infection clinic services, Cape Town, South Africa." Sexual Health 6, no. 4 (2009): 300. http://dx.doi.org/10.1071/sh09046.

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Background: Condoms offer the most realistic and available protection against sexually transmissible infections (STIs), including HIV infection. The protective benefits of condoms are, however, compromised by breaks and tears. The objective of the present study was to examine condom failure and associated behavioural risk factors among men at high-risk for HIV transmission in South Africa. Methods: Men (n = 431) receiving STI treatment services at a public clinic completed computer assisted interviews and STI clinic chart abstraction over a 1-year observation period. Results: One in three male STI clinic patients reported a history of condom failure. Condom failure was associated with sexual exchange, alcohol and other drug use, and higher rates of unprotected vaginal intercourse. Men with a history of condom failure were significantly more likely to have an STI diagnosis 1 month before the baseline interview and were significantly more likely to be diagnosed with an STI over the subsequent year. Conclusion: Condom failures are common among STI clinic patients and pose a threat for increased HIV transmission risks.

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Neuman, Manuela G., Michelle Schneider, Radu M. Nanau, and Charles Parry. "Alcohol Consumption, Progression of Disease and Other Comorbidities, and Responses to Antiretroviral Medication in People Living with HIV." AIDS Research and Treatment 2012 (2012): 1–14. http://dx.doi.org/10.1155/2012/751827.

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The present paper describes the possible connection between alcohol consumption and adherence to medicine used to treat human deficiency viral (HIV) infection. Highly active antiretroviral therapy (HAART) has a positive influence on longevity in patients with HIV, substantially reducing morbidity and mortality, including resource-poor settings such as South Africa. However, in a systematic comparison of HAART outcomes between low-income and high-income countries in the treatment of HIV-patients, mortality was higher in resource-poor settings. Specifically, in South Africa, patients often suffer from concomitant tuberculosis and other infections that may contribute to these results. Alcohol influences the use of medicine for opportunistic infections (e.g., pneumonia, tuberculosis), or coinfections HIV-hepatitis viruses-B (HBV) and C (HCV), cytomegalovirus, or herpes simplex virus. Furthermore, alcohol use may negatively impact on medication adherence contributing to HIV progression. The materials used provide a data-supported approach. They are based on analysis of published (2006–2011) world literature and the experience of the authors in the specified topic. Intended for use by health care professionals, these recommendations suggest approaches to the therapeutic and preventive aspects of care. Our intention was to fully characterize the quality of evidence supporting recommendations, which are reflecting benefit versus risk, and assessing strength or certainty.

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Majam, Mohammed, Naleni Rhagnath, Vanessa Msolomba, Leanne Singh, Michael S. Urdea, and Samanta T. Lalla-Edward. "Usability and Clinical Performance Characteristics of the Asante HIV1/2 Test by Trained Users in Two African Sites." Diagnostics 11, no. 9 (September 20, 2021): 1727. http://dx.doi.org/10.3390/diagnostics11091727.

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HIV self-testing (HIVST) devices are acknowledged as having the potential to enable the acceleration of HIV diagnosis and linkage to care. How efficiently professional and trained users engaged with the Asante HIV-1/2 Oral Self-Test (Asante) (Sedia Biosciences, Portland, OR, USA), and the accuracy of the device in comparison to other HIV rapid diagnostic tests (RDT), was assessed to be able to guide the development and adoption of the device in Senegal and South Africa. Using convenience sampling, potential participants were recruited from catchment areas where HIV was prevalent. Trained users performed an HIV test on participants using an Oral HIVST. The professional user’s interpretation of results was then measured against the results of various other RDTs. The South African study had 1652 participants and the Senegalese, 500. Most of the participants in each study were 18–35 years old. Senegal had a higher number of females (346/500, 69.2%) compared to South Africa (699/1662, 42.1%). Asante displayed very high sensitivity and specificity when tested against other devices. In the final enzyme-linked immunosorbent assay (ELISA) comparison, in South Africa, the sensitivity: specificity was 99.1:99.9% and in Senegal, 98.4:100.0%. Senegal further identified 53/63 (84.1%) with HIV-1, 8/63 (12.7) with HIV-2 and 2/63 (3.2%) with HIV-1/2 co-infections. Professional or trained users’ interpretations of Asante results correlated strongly to results when using various RDTs, the ELISA assay and Western blot tests, making it a dependable HIV testing instrument.

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Lewis, D. A. "5. HIV AND WOMEN: THE AFRICAN EXPERIENCE." Sexual Health 4, no. 4 (2007): 286. http://dx.doi.org/10.1071/shv4n4ab5.

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Africa as a continent has been devastated by the acquired immunodeficiency syndrome epidemic caused by the human immunodeficiency virus (HIV). Women are more likely to acquire HIV/AIDS for a number of reasons and incidence studies show that younger women are particularly at risk of HIV acquisition. Biologically, they are more vulnerable and the acquisition of HIV can be influenced by hormonal contraceptives as well as sexually transmitted infections, which are often more asymptomatic than is the case for men. Women in Africa are also more vulnerable because of cultural issues; in some countries polygamy is accepted practice. Women are often economically disadvantaged and disempowered. It is often hard for them to insist on the use of condoms with husbands and regular partners. Physical and sexual abuse of women, including rape, remains a major problem on the continent, particularly in times of civil war. Many women are forced to work as sex workers or be involved in transactional sex in order to survive. Most countries rely on anonymous antenatal surveys to generate HIV seroprevalence data for women of reproductive age. These data is often used as surrogate markers for HIV prevalence rates in men of a similar age. The seroprevalence of HIV among pregnant women differs remarkably around the continent, with the highest rates being seen in Southern Africa, as high as 30%, and much lower rates being seen in West Africa. These reasons underlying these differences are complex and not completely understood. UNAIDS estimated in 2005 that 470�000 (87%) of the world's 540�000 newly infected children (<15 years old) reside in Sub-Saharan Africa. Prevention of mother to child transmission (PMTCT) of HIV is thus a national priority in many Sub-Saharan African countries. Despite policies, treatment is sometimes not given at the clinic level for several reasons, and when it is, most commonly it is with single dose Nevirapine. Data from South Africa has shown that both mothers and infected babies rapidly acquire nevirapine resistance. It is likely that this will lead to early failure of first line antiretroviral (ARV) therapy among these mothers once they start their ARVs. In South Africa, for example, either efavirenz or nevirapine form the backbone of the first-line ARV regimens. AIDS defining illnesses (ADIs) in women living in Africa are similar to those observed in men. Tuberculosis is the most common ADI but other life-threatening illnesses such as cryptococcal meningitis are relatively common compared to other parts of the world. Cervical cancer and cervical intra-epithelial neoplasia (CIN) lesions are more common in HIV-infected than in non-infected women. Most countries in Africa do not have cervical screening programmes and, even in richer countries such as South Africa, the national policy is to screen women three times in their life at 30, 40 and 50 years of age. Many HIV specialist centres, with additional donor funds, are now attempting to perform annual cervical screening, at least in South Africa.

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Vandormael, Alain, Diego Cuadros, Hae-Young Kim, Till Bärnighausen, and Frank Tanser. "The state of the HIV epidemic in rural KwaZulu-Natal, South Africa: a novel application of disease metrics to assess trajectories and highlight areas for intervention." International Journal of Epidemiology 49, no. 2 (January 13, 2020): 666–75. http://dx.doi.org/10.1093/ije/dyz269.

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Abstract Background South Africa is at the epicentre of the HIV pandemic, with the world's highest number of new infections and the largest treatment programme. Using metrics proposed by the Joint United Nations Programme on AIDS (UNAIDS), we evaluate progress toward epidemic control and highlight areas for intervention in a hyperendemic South African setting. Methods The Africa Health Research Institute (AHRI) maintains a comprehensive population-based surveillance system in the Hlabisa sub-district of KwaZulu-Natal. Between 2005 and 2017, we tested 39 735 participants (aged 15–49 years) for HIV and followed 22 758 HIV-negative and 13 460 HIV-positive participants to identify new infections and all-cause AIDS-related deaths, respectively. Using these data, we estimated the percentage reduction in incidence, the absolute incidence rate, the incidence-mortality ratio and the incidence-prevalence ratio over place and time. Results We observed a 62% reduction in the number of new infections among men between 2012 and 2017 and a 34% reduction among women between 2014 and 2017. Among men, the incidence-mortality ratio peaked at 4.1 in 2013 and declined to 3.1 in 2017, and among women it fell from a high of 6.4 in 2014 to 4.3 in 2017. Between 2012 and 2017, the female-incidence/male-prevalence ratio declined from 0.24 to 0.13 and the male-incidence/female-prevalence ratio from 0.05 to 0.02. Conclusions Using data from a population-based cohort study, we report impressive progress toward HIV epidemic control in a severely affected South African setting. However, overall progress is off track for 2020 targets set by the UNAIDS. Spatial estimates of the metrics, which demonstrate remarkable heterogeneity over place and time, indicate areas that could benefit from additional or optimized HIV prevention services.

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Noah, Barbara A. "AIDS and Antiretroviral Drugs in South Africa: Public Health, Politics, and Individual Suffering: A Review of Brian Tilley's It's My Life." Journal of Law, Medicine & Ethics 31, no. 1 (2003): 144–48. http://dx.doi.org/10.1111/j.1748-720x.2003.tb00064.x.

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The word “epidemic” seems inadequate to describe the spread of the HIV virus in sub-Saharan Africa. The latest estimates suggest that 28.5 million people in this region are infected, including 5 million in South Africa alone. The HIV and AIDS pandemic, with infection rates of over 20 percent in seven African countries, rivals the worst of history's disease outbreaks, including the bubonic plague of medieval times. The devastating effects of the disease on the continent are compounded by extreme poverty in the region and the lack of medical infrastructure essential for delivering the full range of available treatments for HIV infection, AIDS, and the opportunistic infections associated with the disease. Of the 40 million people infected with HIV worldwide, only 730,000 receive combination antiretroviral therapies. In the entire African continent, only 30,000 infected people currently receive such forms of treatment.

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Gobind, Jenni, and Wilfred Isioma Ukpere. "Effectiveness of HIV/AIDS voluntary counselling and testing at a university in South Africa." Corporate Ownership and Control 12, no. 3 (2015): 522–33. http://dx.doi.org/10.22495/cocv12i3c5p4.

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The increasing prevalence rates of HIV amongst South Africans 20 years and above, raises a concern as to the rising trend of the epidemic in similar age group within Higher Education Institutions (HEIs). Higher Education HIV/AIDS Programme (HEAIDS), in conjunction with HEIs and the South African government have undertaken to implement HIV/AIDS workplace programmes within universities in South Africa. Voluntary Counselling and Testing (VCT) is a critical component of most universities HIV/AIDS workplace programmes. The rationale for promoting VCT is to encourage testing. An uptake in testing offers a crucial benefit, participants become aware of their status, and in most instances this awareness leads to safer sexual practices which in turn help reduce the number of new infections. A dominate sequential explanatory mixed methodology was adopted for the study. However, the quantitative method was dominant in the mixed method. A sample size of 739 respondents responded to the flouted questionnaire during the quantitative phase. This was followed by the qualitative interview of which 14 participants answered the semi structured interview questions. The findings revealed that more respondents are aware of the availability of VCT sessions, when compared to the number of respondents who actually participated in the testing. It was further disclosed in the findings that awareness of the availability of VCT sessions at the university unfortunately does not amount to testing and thus does not result in the intended changes sought after by HEAIDS or the Department of Education. Research suggests that HEIs are not really helping students to realise their right to remain HIV negative. HEIs need to be concerned, and HIV/AIDS institutional offices, in particular, need to revisit the VCT with the intention of re-attracting student and staff participation

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Kharsany, Ayesha B. M., Lyle R. McKinnon, Lara Lewis, Cherie Cawood, David Khanyile, Domiciled Venessa Maseko, Tawni C. Goodman, et al. "Population prevalence of sexually transmitted infections in a high HIV burden district in KwaZulu-Natal, South Africa: Implications for HIV epidemic control." International Journal of Infectious Diseases 98 (September 2020): 130–37. http://dx.doi.org/10.1016/j.ijid.2020.06.046.

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Wand, Handan, Claire Whitaker, and Gita Ramjee. "Geoadditive models to assess spatial variation of HIV infections among women in Local communities of Durban, South Africa." International Journal of Health Geographics 10, no. 1 (2011): 28. http://dx.doi.org/10.1186/1476-072x-10-28.

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Kalichman, Seth C., Leickness C. Simbayi, Redwaan Vermaak, Demetria Cain, Sean Jooste, and Karl Peltzer. "HIV/AIDS Risk Reduction Counseling for Alcohol Using Sexually Transmitted Infections Clinic Patients in Cape Town, South Africa." JAIDS Journal of Acquired Immune Deficiency Syndromes 44, no. 5 (April 2007): 594–600. http://dx.doi.org/10.1097/qai.0b013e3180415e07.

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Swanepoel, P. J., P. Michelow, R. Du Plessis, I. G. Proudfoot, G. A. Tarr, S. L. Bockel, and C. J. Swanepoel. "Cervical squamous intraepithelial lesions and associated cervical infections in an HIV-positive population in Rural Mpumalanga, South Africa." Cytopathology 24, no. 4 (July 23, 2012): 264–71. http://dx.doi.org/10.1111/j.1365-2303.2012.00998.x.

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Lohrmann, G. M., B. Botha, A. Violari, and G. E. Gray. "HIV and the urban homeless in Johannesburg." Southern African Journal of HIV Medicine 13, no. 4 (October 4, 2012): 174. http://dx.doi.org/10.4102/sajhivmed.v13i4.111.

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Background. There are few data on HIV prevalence and risk factors among inner-city homeless and marginally housed individuals in South Africa. Methods. We recruited 136 adults from a Johannesburg inner-city homeless clinic; mean age was 32.4 years, 129 (95%) were male, and 90 (66%) were of South African nationality. Participants were tested for HIV and answered a short demographic survey. Descriptive statistics and uni- and multivariate regression analyses were used for data analysis. Results. The HIV prevalence in the cohort was 23.5%. Transactional sex, relationship status, number of concurrent sexual partners, condom usage and history of previously treated sexually transmitted infections (STIs), living on the street, the use of alcohol or drugs, and previous exposure to voluntary counselling and testing (VCT), were not significant risk factors for HIV-positivity. Statistically significant HIV risk factors on multivariate analysis included the presence of an STI (odds ratio (OR) 5.6; p

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Livingston, Mahala, Pavitra Pillay, Siphosenkosi Gift Zulu, Leiv Sandvik, Jane Dene Kvalsvig, Silindile Gagai, Hashini Nilushika Galappaththi-Arachchige, et al. "Mapping Schistosoma haematobium for Novel Interventions against Female Genital Schistosomiasis and Associated HIV Risk in KwaZulu-Natal, South Africa." American Journal of Tropical Medicine and Hygiene 104, no. 6 (June 2, 2021): 2055–64. http://dx.doi.org/10.4269/ajtmh.20-0679.

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Abstract.Women with female genital schistosomiasis (FGS) have been found to have genital symptoms and a three-fold higher risk of HIV infection. Despite WHO recommendations, regular antischistosomal mass drug administration (MDA) has not yet been implemented in South Africa possibly because of the lack of updated epidemiological data. To provide data for future prevention efforts against FGS and HIV, this study explored Schistosoma haematobium prevalence in girls and young women and the effects of antischistosomal MDA, respectively. Urinary schistosomiasis and genital symptoms were investigated in 70 randomly selected secondary schools in three districts within KwaZulu-Natal and 18 primary schools. All study participants were treated for schistosomiasis, and schools with the highest urinary prevalence were followed up after 1 and 4 years of MDA. At baseline, urine analysis data showed that most schools were within the moderate-risk prevalence category where biennial antischistosomal MDA is recommended, as per WHO guidelines. Young women had high prevalence of genital symptoms (36%) after correcting for sexually transmitted infections. These symptoms may be caused by infection with schistosomes. However, FGS cannot be diagnosed by urine analysis alone. In KwaZulu-Natal rural schools, this study suggests that antischistosomal MDA with praziquantel could prevent genital symptoms in more than 200,000 young women. Furthermore, it is feasible that more than 5,000 HIV infections could be prevented in adolescent girls and young women by treatment and prevention of FGS.

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Shastri, S., A. Shet, B. Rewari, and A. De Costa. "HIV-1 discordant couples in Karnataka, South India: is the sex ratio of index cases changing?" International Journal of STD & AIDS 23, no. 7 (July 2012): 502–6. http://dx.doi.org/10.1258/ijsa.2011.011352.

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India has an estimated 2.5 million HIV infections, most of which are heterosexually transmitted. Women comprise 40% of infected adults. In India, 90% of women between the ages of 15 and 45 years are married. Previous literature has suggested that sexual intercourse with an HIV-infected husband represents a married woman's greatest risk for being infected. However, a recent meta-analysis of discordant couples from sub-Saharan Africa reported that women were the index case in half of all couples. Similar data are not available from India. This cross-sectional study describes the epidemiology of 925 discordant couples from five districts in Karnataka province, one of the high HIV prevalence provinces in India. Men were the index case in 74% of couples. However, in young couples (where the index case was aged <30 years), women were more likely to be the infected partner (64% of couples). Condom use was reported by 46% of these discordant couples. These results suggest an emerging predominance of female index case infections among younger discordant couples in India, and point to the need for focusing HIV preventive messages on youth and couples before marriage.

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Pathirana, Jayani, Michelle Groome, Jeffrey Dorfman, Gaurav Kwatra, Suresh Boppana, Clare Cutland, Stephanie Jones, and Shabir A. Madhi. "Prevalence of Congenital Cytomegalovirus Infection and Associated Risk of In Utero Human Immunodeficiency Virus (HIV) Acquisition in a High-HIV Prevalence Setting, South Africa." Clinical Infectious Diseases 69, no. 10 (January 7, 2019): 1789–96. http://dx.doi.org/10.1093/cid/ciz019.

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Abstract Background There is a paucity of data on the burden of congenital cytomegalovirus (cCMV) infections in low- and middle-income countries, including their association with maternal human immunodeficiency virus (HIV) infections. We investigated the prevalence of cCMV in a patient population with a high rate of HIV and antiretroviral therapy (ART) use during pregnancy in Soweto, Johannesburg. Methods Saliva from neonates were screened for cytomegalovirus (CMV) infection by polymerase chain reaction (PCR) at birth. Additional saliva and urine samples were tested within 3 weeks of birth to confirm positive saliva results. HIV PCR testing was done on the whole blood of HIV-exposed neonates. Maternal and neonatal data were extracted from clinical records. Results Of 2685 neonates screened for cCMV, 828 (31%) were born to HIV-infected women, 95% of whom (790/828) were on ART at delivery. The overall prevalence of cCMV was 2.5% (95% confidence interval [CI] 1.9–3.2), with significantly higher cCMV prevalence in HIV-exposed neonates (5.2%, 95% CI 3.8–6.9) than HIV-unexposed neonates (1.4%, 95% CI 0.9–2.0). The risk of in utero HIV infection was 20-fold greater (odds ratio 20.1, 95% CI 6.09–66.46) in HIV-exposed, cCMV-infected neonates, and this increased risk was not associated with the maternal CD4+ T-cell count or the maternal duration of ART. Conclusions The prevalence of cCMV in our setting is substantially higher than the global estimate of 0.64%, partly due to the increased susceptibility for cCMV in HIV-exposed neonates. The significantly increased risk of in utero HIV infection in neonates with cCMV indicates that CMV coinfection plays a major role in the residual burden of in utero HIV transmission, even in the era of ART.

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Speizer, Ilene S., Mahua Mandal, Khou Xiong, Aiko Hattori, Ndinda Makina-Zimalirana, Faith Kumalo, Stephen Taylor, Muzi S. Ndlovu, Mathata Madibane, and Andy Beke. "Methodology and Baseline Results From the Evaluation of a Sexuality Education Activity in Mpumalanga and KwaZulu-Natal, South Africa." AIDS Education and Prevention 30, no. 2 (April 2018): 152–68. http://dx.doi.org/10.1521/aeap.2018.30.2.152.

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In South Africa, adolescents and young adults (ages 15–24) are at risk of HIV, sexually transmitted infections, and unintended pregnancies. Recently, the Department of Basic Education has revised its sexuality education content and teaching strategies (using scripted lessons plans) as part of its life orientation curriculum. This paper presents the methodology and baseline results from the evaluation of the scripted lesson plans and supporting activities. A rigorous cluster-level randomized design with random assignment of schools as clusters is used for the evaluation. Baseline results from grade 8 female and male learners and grade 10 female learners demonstrate that learners are at risk of HIV and early and unintended pregnancies. Multivariable analyses demonstrate that household-level food insecurity and living with an HIV-positive person are associated with sexual experience and pregnancy experience. Implications are discussed for strengthening the current life orientation program for future scale-up by the government of South Africa.

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Schenker, Inon. "Cutting-Edge Success in Preventing Heterosexual HIV Transmission in Africa: Voluntary Medical Male Circumcision Has Reached 15 Million Men." AIDS Education and Prevention 30, no. 3 (June 2018): 232–42. http://dx.doi.org/10.1521/aeap.2018.30.3.232.

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Male circumcision is a minor surgery performed for religious and medical reasons. Three randomized clinical trials demonstrated it could reduce heterosexual HIV transmission from infected females to males by over 60%, paving the way in 2006 for multinational efforts to circumcise 27 million men in sub-Saharan Africa by 2021. It is estimated that by 2030 male circumcision will avert at least 500,000 HIV infections in Africa, saving lives and budgets. Voluntary medical male circumcision (VMMC) of adults and adolescents has challenged policy makers, implementers, funders, and civil society in bringing surgery to the frontline of HIV prevention. Five key challenges are discussed: policy, clinical, demand, supply, and scaling up. A unique Israel-Senegal-South Africa collaboration, which enhanced high-volume (100 VMMCs per day) and high-quality (less than 2% minor adverse events) procedures, is described, highlighting VMMC as one of the most impressive public health collaborative interventions in HIV/AIDS prevention globally.

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Morikawa, E., M. Mudau, D. Olivier, L. de Vos, D. Joseph Davey, C. Price, J. A. McIntyre, R. P. Peters, J. D. Klausner, and A. Medina-Marino. "Acceptability and Feasibility of Integrating Point-of-Care Diagnostic Testing of Sexually Transmitted Infections into a South African Antenatal Care Program for HIV-Infected Pregnant Women." Infectious Diseases in Obstetrics and Gynecology 2018 (2018): 1–6. http://dx.doi.org/10.1155/2018/3946862.

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Background. Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) infections may increase the risk of vertical transmission of the human immunodeficiency virus (HIV). In resource-limited settings, symptomatic screening, and syndromic management of sexually transmitted infections (STIs) during pregnancy continue to be the standard of care. In the absence of diagnostic testing, asymptomatic infections in pregnant women go untreated. Objective. To describe the acceptability and feasibility of integrating diagnostic STI screening into first antenatal care visits for HIV-infected pregnant women. Methods. HIV-infected pregnant women were recruited during their first antenatal care visit from three antenatal care clinics in Tshwane District, South Africa, between June 2016 and October 2017. Self-collected vaginal swabs were used to screen for CT, NG, and TV with a diagnostic point-of-care (POC) nucleic acid amplification test. Those with STIs were provided treatment per South African national guidelines. Results. Of 442 eligible women, 430 (97.3%) agreed to participate and were tested. Of those with a positive STI test result (n = 173; 40.2%), 159 (91.9%) received same-day results and treatment; 100% of STI-infected women were treated within seven days. Conclusions. Integration of POC diagnostic STI screening into first-visit antenatal care services was feasible and highly acceptable for HIV-infected pregnant women.

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Wand, Handan, and Gita Ramjee. "Biological impact of recurrent sexually transmitted infections on HIV seroconversion among women in South Africa: results from frailty models." Journal of the International AIDS Society 18, no. 1 (January 2015): 19866. http://dx.doi.org/10.7448/ias.18.1.19866.

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Journal articles on the topic 'HIV infections – South Africa – Soshanguve'

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