The 2011 National Antenatal HIV & Syphilis Prevalence Survey has been released. Read the report here.

2011 National Antenatal HIV & Syphilis Prevalence Survey

 

The HIV sentinel surveillance data has helped to map the epidemic and monitor HIV infection trends in the country and has served as an advocacy tool, resulting in the mobilization of partners, resources and development of innovative approaches by the national response to HIV and AIDS. The 2011 HIV survey was the 22nd round to be conducted in the country by the Department of Health.

 

The South African antenatal clinic survey is done annually in October to obtain an estimate of the point prevalence for that year. The data set generated from this survey is used by mathematical modelers such WHO/UNAIDS reference group and others to estimate the rate of new HIV infections(incidence) and HIV-associated deaths are derived through mathematical models applied to HIV prevalence estimates.

 

The Department of Health will continue to sustain and enhance the use of this robust Unlinked anonymous HIV surveillance methodology to monitor the HIV epidemic trend in South Africa through conducting annual HIV antenatal sentinel surveillance at national, provincial and district levels. The HIV epidemic in South Africa has in the last 6 years shown stabilization, particularly among antenatal care first time bookers in their current pregnancy served in public health sector clinics. In 2011, a total of 33 446 first time antenatal care attendees participated in the survey. This was a representative sample to make conclusive inferences on the HIV and syphilis occurrence at National and Provincial level and in all 52 Health Districts.

 

The survey epidemiological design uses a cross-sectional unlinked anonymous testing method using blood samples collected for other purposes in selected sentinel primary health care facilitates. This sampling approach is convenient because, as part of the antenatal care services it is mandatory to routinely draw blood from the first bookers, and this minimises participation bias and reduces costs.

 

In addition, pregnant women are universally the most common Sentinel Population for HIV and in South Africa the most common mode of transmission is the heterogeneous sexual route. It is not perfectly representative of all women and even less of men, children and non-pregnant women, but it is an important means of coverage for countries that have a generalized HIV epidemic (i.e. where HIV prevalence among pregnant women is >2%) and it also has a wide geographic coverage (urban; informal settlements and rural communities).

 

Intravenous blood samples are collected from the pregnant first bookers in their current pregnancy, recruited from 1 445 public sector antenatal clinics every month of October since 1990. Their full intravenous blood specimens were collected and sent to central pathology laboratories in the various provinces for HIV and syphilis analysis. The laboratory diagnostic test used were the highly specific and sensitive Enzyme Linked Immuno Sorbent Assay (ELISA) for HIV antigen testing and the Rapid Plasma Reagin (RPR) card test for active syphilis. Given that the sentinel sites were chosen on a probability proportional to size basis by district, the sampling period was fixed and the districts samples were self-weighting, the provincial prevalence estimates were calculated as the total of the results from the districts in the provinces. The national prevalence was weighted according to the total number of women aged 15 - 49 years in each province using the 2011 midyear population size estimates.

 

The sentinel population (participants) who agreed to participate in the survey has increased from 32 255 in 2010 to 33 446 in 2011 of the targeted 36 000 pregnant women attending antenatal care. The sample population realization rate in 2011 was 92.9% which exceeds 70% compliance as outlined in the survey protocol.

 

This article is courtesy of Health-e News Service.

 

Counting progress on AIDS response

Published in Featured Articles
Saturday, 08 December 2012 13:57

 

Taking stock of the country’s performance in addressing AIDS, Health Minister Dr Aaron Motsoaledi, noted that over about 20 million South Africans have tested for HIV in the last two years and that HIV transmission from mother to child has dropped to below 3%. But Motsoaledi cautioned that much still needs to be done.

 

“I don’t want you to tire of it, lest we forget we have got an epidemic here around the world which is going to be with us for the next 30 years – an epidemic that (is) responsible for close to one-third of the deaths in our country. There is no way we can ever forget about it and tire”, Health Minister, Dr Aaron Motsoaledi, urged South Africans not to be too complacent about HIV.

 

With a sense of accomplishment, Motsoaledi said the number of people who have tested for HIV has increased over the last two years, while the rate of HIV transmission from mother to child has dropped significantly in four years and medical male circumcision as a means of preventing HIV infection in men is also gaining momentum.

 

“We have exceeded the target of testing 15 million people. Twenty million people have been tested for HIV/AIDS since we launched the campaign in April 2010. We have reduced the rate of mother-to-child (HIV) transmission from 8% in 2008 to 3.5% in 2010 and down to 2.7% in 2011. Our medical male circumcision programme, which is under way, is doing very well. We have circumcised 600 000 people who were not circumcised before we launched the programme. That one province of KwaZulu-Natal is dreaming of circumcising, at least, two million males by 2015. From the way it’s going, we think we are on course”, he said.

 

HIV prevention efforts need increased support as prevention remains the only way to reduce the scourge of the epidemic.

 

“It is very clear that if we don’t put a lot of effort in prevention, we might not be able to win our battle. It speaks to the need for every individual to know their status”, added Zwo Nevhutalo, the chief operating officer for the South African National AIDS Council (SANAC).

 

“We are hoping that every South African will develop a tendency to test, at least, once per annum. And I mean every South African, including the young ones”, Health Minister, Dr Aaron Motsoaledi, echoed Nevhutalo’s sentiment.

 

He painstakingly made a point why children should be targeted in HIV testing efforts.

“We are regarded as a country which is very poor in educating children about sex in schools. We need to take this campaign to schools – reproductive health rights, including family planning and sexuality education, HIV counseling and testing in schools”.

 

“Ninety-four thousand kids fell pregnant last year in schools in South Africa. In addition, 77 000 committed abortions in public hospitals. I don’t know back-street… I don’t know private hospitals… I don’t know private surgeries. The National Confidential Enquiry on Maternal Mortality reported that young girls in South Africa below the age of 18 years contribute to 8% of the pregnancies. But when it comes to death they contribute 36% of the total maternal deaths because they are too young to fall pregnant. They should not have fallen pregnant. Where do you find 18-year olds? Where do you find them? They are at school. And if I have to stop them from dying we need to have a school health programme where we’ll teach young girls. We need to have a reproductive health programme. We need to teach them about sexuality education. Other nations are doing so”, Motsoaledi said.

 

As of the most recent World AIDS Day into the coming year, Motsoaledi said efforts will also be made to target men to increase their awareness about HIV infection.

 

“In this fight against HIV and AIDS, men are very slippery… very, very slippery, I must tell you. We’re trying to find a way to capture them. They are slippery in that when we check the statistics on the HCT campaign, 65% of the people who participate – who want to know their status – are women. Five percent are children and only 35% are men”.

 

“But when we check how HIV/AIDS is propagated, men are central. If you were to theoretically remove men from the planet and put them somewhere for about 10 years, believe you me when you bring them back, AIDS will be gone completely. This is not a joke. It could happen. Scientifically, it’s like that. (It’s) only that humanly and practically, it’s not possible”, he said.

 

He also committed to making treatment more accessible to those who need it, projecting that within two to three years about 2.5 million South Africans will be receiving antiretroviral therapy.

“At this juncture, we know that 1.7 million (people) are on treatment in South Africa. We have achieved that by increasing ARV treatment sites. The ARV treatment sites in February 2010 were only 490. Today, we proudly mention that we now have 3 000 facilities which are well-equipped to initiate ARV treatment. We are hoping that by 2015 or even 2014, for that matter, the number of people on treatment might reach 2.5 million”, Motsoaledi said.

 

This article is courtesy of Health-e News Service.

 

 

mortalityGovernment’s annual death report has confirmed the trend that fewer South Africans have been dying of HIV/AIDS-related diseases. However, more people are dying of non-communicable diseases such as diabetes.

 

Released in the Free State yesterday morning (10 April), the Statistics SA report Mortality and causes of death in South Africa, 2010: Findings from death notification, records and analyses deaths reported in 2010 as it is written on death certificates completed by doctors and others certified to do so. The findings were released in Thabo Mofutsanyane district in Phuthaditjhaba, which recorded the highest death rate in the country.

 

KwaZulu-Natal and Gauteng had the highest overall number of deaths in 2010.

 

In summary, the number of deaths processed by Stats SA in 2010 was 543 856, a 6.2% decline from the year before with the highest number of deaths among those aged 35-39 and 30-34. Overall, there were slightly more male than female deaths.

 

In 2010, the average age at death was estimated at around 48 years, which has increased by about five years since 2004.

 

Tuberculosis was the leading cause of death (11.6%), a spot it has held for a number of years. Influenza and pneumonia is in second spot followed by intestinal infectious diseases. However, the number of deaths attributed to these three conditions has consistently and significantly decreased, while those due to diabetes are increasing – 3,8% in 2010.

 

Looking at the report from an HIV point-of-view, University of Cape Town (UCT) actuary and epidemiologist Leigh Johnson, says the report shows evidence of continued declines in HIV-related mortality, which is likely to be a reflection of the success of the antiretroviral treatment programme. “Although there has been a slight increase in the number of deaths that are recorded as being due to HIV when comparing 2010 to 2009, there have been very substantial reductions in deaths reported as being due to TB, pneumonia, influenza and intestinal infectious diseases,” says Johnson.

 

These three diseases are causes to which HIV deaths are most frequently mis-attributed, in other words they are recorded as such on death certificates instead of being noted as HIV deaths.

 

Johnson notes that there have also been relatively large reductions in mortality in young adults (roughly 30% reduction in overall mortality rates in the 30-39 age group between 2006 and 2010). “All of this is consistent with what we would expect with declining AIDS mortality,” Johnson adds.

Rob Dorrington, Professor of Actuarial Science at UCT says it is “good” that the report has been released because mortality rates and patterns are changing quite rapidly, particularly due to the huge increase in the provision of antiretrovirals.

 

In addition estimates of mortality rates are important for checking the sensibleness of the 2011 census results.

 

However, he expressed concern that the report is almost five months late. “This is only acknowledged deep within the report and the explanation for the delay (as “improvements in data processing methodology and processing systems”) leaves one worrying about when future reports will become available.”

 

Dorrington agrees with Johnson that it is “hugely apparent” that HIV/AIDS deaths are hidden as a cause of death, which distorts the interpretation of rankings of the causes of deaths hugely – not only contributing to the ranking of TB at the top of the causes, but also contributing to the high ranking of some other causes.

 

Dorrington said that although the total number of deaths has fallen, much as expected, the numbers of deaths have increased in the 1-14 age range and the 80-84 age group (particularly for females).

 

“Although the report acknowledges that not all deaths in South Africa are captured by the system, the estimate of 93% completeness that they cite applies only to adults. A higher percentage of child deaths, particularly those under age 5 go unregistered,” Dorrington points out.

 

The report also reveals that almost half of the deaths took place in health facilities. Free States and North West had the highest proportion of children dying in infancy while Western Cape and Eastern Cape had the highest proportions of deaths occurring in old ages.

 

This article is courtesy of Health-e News Service

 

 

Putting a ring on it helps close HIV loop

Published in Featured Articles
Monday, 24 June 2013 13:45

Marriage apparently has a condom effect, with the HIV rate amongst married South Africans half that that of unmarried people.

 

Almost one-fifth (19.2%) of unmarried South Africans are living with HIV as opposed to 9.8% of married people. In addition, unmarried people were five times more likely to have had more than two sexual partners in the past year.

 

These findings were part of the Human Science Research Council’s 2012 Household Survey, conducted nationally every four years, the highlights of which were released in the past week at the national AIDS conference.

 

Given that seven out of 10 South Africans over 16 (when marriage becomes legal) are unmarried, this is a challenge for government HIV experts.

 

The AIDS conference was in many senses a straw poll of Health Minister Dr Aaron Motsoaledi’s four-year term in the ministry, but the significant national progress reported was partly undermined by ongoing provincial problems.

 

Concluded in Durban on Friday, the conference was told that over two million people were on antiretroviral (ARV) treatment by mid-2012. In addition, only 7.3% of young people aged 15-24 were now living with HIV, in comparison to 10.3% in 2005. These finding were also part of the Household Survey.

 

Releasing select survey highlights (the full report will only be ready in about eight weeks’ time), HSRC head Dr Olive Shisana said “at last the glass is half full”.

 

While the proportion of South Africans now living with HIV has increased from 10.6% in the 2008 to 12.3% in 2012, this is partly because people with HIV are on treatment and living longer.

 

This is supported by HIV prevalence which now peaks five years later for men and women than in the three previous surveys, indicating that the worst-affected age groups of years gone by are alive and aging.

 

The highest HIV prevalence rate in women is now in the 30-34 age group (36.8% living with HIV) and in men aged 35-39 (24.2%).

 

“I am pleased to see that more people with HIV are living longer because of the large ARV treatment programme of government. I am equally delighted to see that there has been a decline of HIV prevalence among youth aged 15 – 24 years,” said Shisana.

 

The start of the long-awaited AIDS vaccine trial to be headed by Professor Glenda Gray was also announced at the conference.

 

Since a vaccine trialed in Thailand was found to be partially effective in 2009, offering 31% protection after a year, South Africa has been in line to test the vaccine further. There is some scepticism about whether the Thai vaccine will work in places with a high HIV rate, which made South Africa the right place to test it further.

 

Delayed in part by the mammoth cost of the 10-year study (around R1.2-billion), Prof Gray announced that it had finally started this week with safety trials on around 100 volunteers in Soweto, Cape Town and Klerksdorp. Should it prove safe in South Africa (and there is no reason why it shouldn't as it was tested on over 10 000 Thai people), proper efficacy trials should begin by 2016.

 

The conference also discussed government’s decision to use a device called PrePex to conduct mass male circumcisions. PrePex has been approved by the World Health Organisation (WHO) unlike the controversial Tara Klamp, which is being used in KwaZulu-Natal. However, PrePex has already courted controversy with Cosatu claiming that it will boycott the “Israeli device”.

 

Government also announced that it will allow patients with multi-drug resistant (MDR) TB to get access to an experimental drug called bedaquidine, which is still in clinical trials. While there are significant side-effects associated with the drug, Phase 2 b trials found that it was effective in treating MDR TB – offering hope to those who are either not responding to the MDR TB drugs currently available or suffering unbearable side-effects.

 

But punching a hole through the progress are the problems of medicine stock-outs, particularly in the Eastern Cape and Gauteng.

 

Last month, 40 percent of the 70 public health facilities surveyed by Medecins sans Frontieres and the Treatment Action Campaign in districts served by the Mthatha medicine depot had experienced shortages of HIV and TB drugs which lasted 45 days on average. Patients at a quarter of these facilities had been sent home empty handed.

 

HIV policies aren’t worth the paper they’re written on if government cannot ensure that those on HIV treatment have a steady supply of antiretroviral medicine. Without this, our HIV programme risks going the same way as our TB programme which for years has been poorly administered and is now plagued by drug-resistant TB that is hard and expensive to treat.

 

The ongoing failure of the Eastern Cape government, and its tendency to deny the extent of the problem, does not inspire confidence that all the provinces are marching together with Motsoaledi in his anti-AIDS crusade.

 

As implementers of policy, the weaker provinces will always be the Achilles Heel of national government and continue to feed the Health Minister’s growing tendency to centralise service delivery.

 

 

Article courtesy of Health-e News Service.

South Africa is an “outstanding model” of what can be achieved in the fight against HIV/AIDS, according to Michel Sidibe, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS).

 

Sidibe was in Pretoria yesterday (Tues 30 July) for the release of the UNAIDS report, “Getting to zero: HIV in eastern and southern Africa”.

 

In the past five years, there has been “extraordinary progress” in reducing HIV in eastern and southern Africa, including a 38% reduction in AIDS-related deaths, according to UNAIDS.

 

Half–a-million fewer Africans died in 2011, including 100 000 fewer South Africans, than in 2005 when AIDS claimed an estimated 1.3-million people. This is largely thanks to a tenfold increase in access to antiretroviral medicine.

 

In a single year – between 2011 and 2012 – an extra one million people in the region got access to ARVs, bringing the number of people on treatment to 6.3-million.

 

One-third of those on ARVs are South Africans, according to UNAIDS.

 

“In 2010, South Africa embarked on an unprecedented national campaign to provide free treatment to all eligible people living with HIV, coupled with a massive programme of testing and counseling for HIV and screening for TB,” according to UNAIDS.

 

“During the last financial year (2012/13), more than nine million people were tested for HIV. The country currently has the largest ART programme in the world, with more than 2.1 million people receiving ART.”

 

A large study in KwaZulu-Natal, the province worst affected by HIV, recorded an 11-year increase in life expectancy in a mere seven years (2007 to 2011).

 

South Africa also managed to slash mother-to-child infection by 50% in two years (between 2009 and 2011), while the region managed to cut HIV infection from mothers to their newborn babies by one-third.

 

“Most countries in the region are within reach of the goal of eliminating new HIV infections among children by 2015 and keeping their mothers alive,” according to UNAIDS.

 

Almost three-quarters of pregnant HIV positive women in the region had access to treatment to prevent transmission to their babies.

 

In the past decade, there has also been a 30% decline in new HIV infections, rolling the infection rate back to the level it was in 1998. In South Africa, new infections amongst adults have dropped by 41%.

 

“In South Africa we have made significant progress in reducing new infections among children. We should keep the momentum going,” said Health Minister Dr Aaron Motsoaledi.

 

“We need to ensure that women continue to benefit from universal access to antiretroviral treatment so that we can reduce maternal mortality. No women or baby should be left behind.”

 

Motsoaledi said while South Africa has made progress in putting 2million people on treatment, aim was to reach 3,5 million people by 2015.

 

Amidst progress, there are still serious weaknesses. Uganda has had a 21% increase in new HIV infections over the past decade, while there have been minimal decreases in Lesotho and Tanzania.

 

In addition, less than a third of HIV positive children were on ARVs, which was “unacceptably low”.

 

“The low ART coverage in children was due to countries not having proper diagnostics and proper following up strategies for mothers with children born with HIV. But a mjor challenge was that there wasn’t a proper treatment regimen catering for children,” says Sidibe

 

Finally, there was an estimated shortfall of $7-billion if all countries were to scale up to meet the HIV challenge.

 

“Ways have to be found to deliver treatment more efficiently and at lower cost. Part of the solution may involve collective investment in the local production of drugs and commodities to drive costs down,” concluded UNAIDS.

 

Article courtesy of Health-e News Service.

SA reduces HIV infection in children by 63%

Published in Featured Articles
Tuesday, 25 June 2013 10:06

MEDIA RELEASE - A new report on the Global Plan towards elimination of new HIV infections among children by 2015 and keeping their mothers alive (Global Plan) has revealed a marked increase in progress in stopping new infections in children across the Global Plan priority countries in Africa.

 

The report outlines that seven countries in sub-Saharan Africa—Botswana, Ethiopia, Ghana, Malawi, Namibia, South Africa and Zambia—have reduced new HIV infections among children by 50% since 2009. Two others—the United Republic of Tanzania and Zimbabwe—are also making substantial progress. It highlights that there were 130 000 fewer new HIV infections among children across the 21 Global Plan priority countries in Africa––a drop of 38% since 2009.

 

“The progress in the majority of countries is a strong signal that with focused efforts every child can be born free from HIV,” said Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “But progress has stalled in some countries with high numbers of new HIV infections. We need to find out why and remove the bottlenecks which are preventing scale-up.”

 

With a 76% decline since 2009, Ghana showed the greatest decline in the rate of new infections among children and South Africa showed a 63% decline (24 000 fewer new HIV infections in 2012 than in 2009). However, the pace of decline in some of the Global Plan priority countries has been slow and in Angola, new HIV infections have even increased. New infections among children in Nigeria––which has the largest number of children acquiring HIV (nearly 60 000 new HIV infections among children in 2012)––remained largely unchanged since 2009. Without urgent action in Nigeria the global target for 2015 may not be reached.

 

More pregnant women living with HIV were receiving antiretroviral medicines to prevent HIV from being transmitted to their children and for their own health in 2012 than in 2009, with coverage levels exceeding 75% in many countries. Increased coverage has reduced HIV transmission rates from mother to child in most countries. Botswana and South Africa have reduced transmission rates to 5% or below.

 

“We have the tools required to reach the Global Plan’s goals, and recent data show that we are moving ever closer to their realization,” said Ambassador Eric P. Goosby, U.S. Global AIDS Coordinator. “This month, as U.S. Secretary of State John Kerry announced, the one millionth baby will be born HIV-free due to PEPFAR’s support. Now, we must all continue working together to see the day when no children are born with HIV, which is within our reach,” he added.

 

The report however also reveals that only half of all breastfeeding women living with HIV or their children receive antiretroviral medicines to prevent mother-to-child transmission of HIV. It outlines that breastfeeding is critical to ensuring child survival and strongly emphasizes the urgent need to provide antiretroviral therapy during the breastfeeding period.

 

More than half of the children eligible for treatment in South Africa and Swaziland now have access. Chad, Ethiopia, Ghana, Kenya, Malawi, Nigeria, South Africa, United Republic of Tanzania and Zimbabwe have doubled the numbers of children accessing treatment from 2009 to 2012. While the report outlines that the number of children requiring HIV treatment will reduce as new HIV infections decline, urgent steps need to be taken to improve early diagnosis of HIV in children and ensure timely access to antiretroviral treatment.

 

The number of pregnant women living with HIV receiving antiretroviral therapy for their own health has increased since 2009. In Botswana, Ghana, Malawi, Namibia, South Africa, Swaziland and Zambia, more than 75% of the pregnant women eligible receive antiretroviral therapy and more than 50% in Kenya, Lesotho, the United Republic of Tanzania and Zimbabwe. Increasing access to antiretroviral therapy for pregnant women living with HIV for their own health is critical.

 

The Global Plan towards elimination of new HIV infections among children by 2015 and keeping their mothers alive is an initiative spearheaded by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United States Presidents Emergency Plan for AIDS Relief (PEPFAR)  which was unveiled in June 2011 at the UN General Assembly High Level Meeting on AIDS. It has two main targets for 2015: a 90% reduction in the number of children newly infected with HIV and a 50% reduction in the number of AIDS-related maternal deaths. The Plan focuses on the 22* countries which account for 90% of new HIV infections among children.

 

This second progress report presents the progress made by the 21 countries in sub-Saharan Africa and some of the challenges they face in meeting the agreed targets for 2015.

 

* Angola, Botswana, Burundi, Cameroon, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, India, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, South Africa, Uganda, United Republic of Tanzania, Swaziland, Zambia and Zimbabwe.

 

 

This article is courtesy of Health-e News Service.

UNAIDS: Less children HIV infected

Published in Featured Articles
Wednesday, 21 November 2012 09:36

South Africa has received global recognition for achieving a significant reduction in the number of children newly infected with HIV.

 

The United Nations Joint Programme on HIV/AIDS (UNAIDS) launched the 2012 Global Epidemic Report yesterday (SUBS: TUES) and praised South Africa for major gains with the number of children newly infected with HIV declining by between 40 and 59 percent from 2009 to 2011.

 

International efforts have focused on ending new infections among children and reducing the number of women living with HIV who die from pregnancy-related causes.

 

According to the report 330 000 children were infected with HIV in 2011, almost halving the rate since 2003 when almost 600 000 children were infected.

 

More than 90% of the children who acquired HIV infection in 2011 live in sub- Saharan Africa, where the number of children newly infected fell by 24% from 2009 to 2011.

 

Sub-Saharan Africa remains most severely affected, with nearly one in every 20 adults living with HIV and accounting for 69% of the people living with HIV worldwide.

 

Worldwide, the number of people newly infected continues to fall. The number of people (adults and children) acquiring HIV infection in 2011 (2.5 million) was 20% lower than in 2001.

 

The sharpest declines in the numbers of people acquiring HIV infection since 2001, have occurred in the Caribbean (42%) and sub-Saharan Africa (25%).

 

During the past decade, many national epidemics have changed dramatically. In 39 countries, the incidence of HIV infection among adults fell by more than 25% from 2001 to 2011.

 

Twenty-three of the countries with steep declines in HIV incidence are in sub-Saharan Africa, where the number of people acquiring HIV infection in 2011 (1.8 million) was 25% lower than in 2001 (2.4 million).

 

However, despite these gains, sub-Saharan Africa accounted for 71% of the adults and children newly infected in 2011.

 

Access to antiretroviral treatment also increased significantly, reaching eight million people by end of 2011 – a 20-fold increase since 2003.

 

More people initiated antiretroviral therapy in 2011 than in any previous year, with the number of people living with HIV receiving treatment rising by 21% compared with data from 2010.

 

This article is courtesy of Health-e News Service.

UNAIDS: Stigma remains a concern

Published in Featured Articles
Thursday, 22 November 2012 09:38

The world is making significant progress in coming to grips with the HIV epidemic, however in many countries stigma and lack of human rights remain.

 

The United Nations Joint Programme on HIV/AIDS (UNAIDS) launched the 2012 Global Epidemic Report yesterday and reported significant declines in new infections among adults and children with high numbers of people placed on antiretrovirals.

 

Still the region most severely affected, sub-Saharan Africa has shown progress with an estimated 1.8-million new HIV infections in 2011 compared with 2.4-million in 2001.

 

Between 2005 and 2011, the number of people dying from AIDS-related causes in sub-Saharan Africa declined by a third from 1.8-million to 1.2-million.

 

Since 2004, the number of tuberculosis-related deaths among people living with HIV has fallen by 28% in sub-Saharan Africa.

 

However, while there have been a number of victories in the treatment and prevention arena – fear, ignorance and discrimination – in its worst forms, including abusive treatment and violence, remain in a number of countries.

 

According to data collected, more than half of people living with HIV in Zambia reported having been verbally abused as a result of their HIV status. One in five people living with HIV in Nigeria and Ethiopia reported feeling suicidal.

 

In Nigeria, more than one in five people living with HIV said they had been denied health services as a result of their HIV infection.

 

According to a nine-country study by the International Labour Organisation and the Global Network of People Living with HIV, the percentage of people living with HIV who reported discriminatory attitudes among employers ranged from 8% in Estonia to 54% in Malaysia.

 

As of 2012, about 60 countries have adopted laws that specifically criminalise HIV transmission, with some 600 convictions reported in 24 countries.

 

According to a 2012 global review, more than 40% of United Nations Member States (78 of 193 countries) criminalise same-sex relations, with some jurisdictions permitting imposition of the death penalty for convictions under such laws.

 

Laws deeming some aspect for sex work to be illegal are in place in the majority of countries and are often used to justify harassment, extortion and violence against sex workers by police and clients, placing them at increased risk of HIV infection.

 

Some countries have reformed laws to decriminalise key populations at higher risk – Portugal decriminalized drug possession and use in 2000 while New Zealand adopted the Prostitution Reform Act 2003 that decriminalized sex work.

 

The report praised South Africa for declines in the number of children newly infected with HIV which went down by between 40 and 59 percent from 2009 to 2011.

 

According to the report 330 000 children were infected with HIV in 2011, almost halving the rate since 2003 when almost 600 000 children were infected.

 

More than 90% of the children who acquired HIV infection in 2011 live in sub- Saharan Africa, where the number of children newly infected fell by 24% from 2009 to 2011.

 

Worldwide, the number of people newly infected continues to fall. The number of people (adults and children) acquiring HIV infection in 2011 (2.5 million) were 20% lower than in 2001.

 

During the past decade, many national epidemics have changed dramatically. In 39 countries, the incidence of HIV infection among adults fell by more than 25% from 2001 to 2011.

 

Twenty-three of the countries with steep declines in HIV incidence are in sub-Saharan Africa, where the number of people acquiring HIV infection in 2011 (1.8 million) was 25% lower than in 2001 (2.4 million).

 

More people initiated antiretroviral therapy in 2011 than in any previous year, with the number of people living with HIV receiving treatment rising by 21 percent compared with data from 2010.

 

This article is courtesy of Health-e News Service.

World has five years to secure victory in HIV fight

Published in Featured Articles
Wednesday, 19 November 2014 12:56

UNAIDSThe world has five years to increase access to HIV treatment and prevention to end HIV as a global health threat – and prevent the pandemic from resurging, according to the latest global HIV report released last night.

 

“We have bent the trajectory of the AIDS epidemic,” said the United Nations Joint United Nations Programme on HIV/AIDS (UNAIDS) in its latest global report released last night. “Now we have five years to break the epidemic or we risk the epidemic springing back even stronger.”

 

The report cautions that eliminating HIV as a global health threat does not necessarily mean no new infections.

 

Instead, ramping up the HIV response through improved access to HIV treatment and prevention for high risk groups like sex workers and men who have sex with men (MSM) will safeguard the world’s gains in reducing new infections and AIDS-related deaths, argues the report.

 

South Africa, alongside many of its neighbours, remains one of the 30 countries responsible for about 90 percent of all new HIV infection globally.

 

The new report scores South Africa high on preventing mother-to-child HIV transmission and on condom use among sex workers. More than 80 percent of HIV-positive expecting mums access antiretrovirals (ARVs) to prevent their unborn children from contracting the virus and a similar percentage of sex workers report using condoms with clients.

 

At the recent Southern African HIV Clinicians Society conference, South African National AIDS Council (SANAC) CEO Dr Fareed Abdullah revealed that recent studies found that more than 70 percent of some sex workers were living with HIV.

 

“For sex workers to have condoms and ARVs confiscated from them when they are arrested is just a blatant violation of rights, which has a direct impact on our programming,” said Abdullah, who launched a national HIV prevention and care plan for sex workers last year.

 

International report echoes local calls for focus on those most at risk

However, South Africa falls short on targets to ensure that 80 percent of adults and children living with HIV are on treatment. This is despite the fact that South Africa’s ARV programme is responsible for about 18 percent of the 13.6 million HIV-positive people that UNAIDS estimates are on treatment in low and middle-income countries.

 

Globally, HIV-positive children remain neglected and are about 40 percent less likely to be on ARVs than adults living with the virus. According to UNAIDS, AIDS-related illnesses remain the largest killer of Africa’s teenagers.

The country also gets low marks for condom use among MSM, less than 50 percent of whom report regular condom use in South Africa.

 

In July, World Health Organisation (WHO) recommended the use of ARVs in HIV-negative men who have sex with men in order to prevent HIV infection.

 

While the Southern African HIV Clinicians Society has released guidelines on the use of the brand name ARV Truvada to prevent HIV infection, the drug is not yet registered for use to prevent HIV. Reacting to the WHO’s announcement in July, Anova Health Institute’s Dr Kevin Rebe said this would prohibit the Department of Health from rolling Truvada out for HIV prevention and called for the registration of the drug to prevent HIV infection a “matter of urgency”.

 

The UNAIDS report recommends that Truvada be offered to HIV-negative sex workers, men who have sex with men and those in long-term relationships in which one partner is living with HIV in order to prevent infection.

 

The UN agency adds that ramping up the HIV response now could also mean a 17-fold return on countries’ investments in the fight.

 

An edited version of this story first appeared in the 19 November edition of  The Star newspaper.

 

This article is courtesy of Health-e News Service.

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