SidaSubSaharaV1, Main, Exploration, bibRecord, 002904

Dramatic increases in HIV prevalence after scale-up of antiretroviral treatment: a longitudinal population-based HIV surveillance study in rural kwazulu-natal

Identifieur interne : 002904 ( Main/Exploration ); précédent : 002903; suivant : 002905

Dramatic increases in HIV prevalence after scale-up of antiretroviral treatment: a longitudinal population-based HIV surveillance study in rural kwazulu-natal

Auteurs : Jaffer Zaidi [Afrique du Sud] ; Erofili Grapsa [Afrique du Sud] ; Frank Tanser [Afrique du Sud] ; Marie-Louise Newell [Afrique du Sud, États-Unis] ; Till B Rnighausen [Afrique du Sud, Royaume-Uni]

Source :

AIDS (London, England) [ 0269-9370 ] ; 2013.

RBID : PMC:4264533

Descripteurs français

KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Antirétroviraux (usage thérapeutique), Enfant, Femelle, Humains, Infections à VIH (traitement médicamenteux), Infections à VIH (épidémiologie), Jeune adulte, Mâle, Population rurale, Prévalence, République d'Afrique du Sud (épidémiologie), Épidémiosurveillance, Études longitudinales.
MESH :
- traitement médicamenteux : Infections à VIH.
- usage thérapeutique : Antirétroviraux.
- épidémiologie : Infections à VIH, République d'Afrique du Sud.
- Adolescent, Adulte, Adulte d'âge moyen, Enfant, Femelle, Humains, Jeune adulte, Mâle, Population rurale, Prévalence, Épidémiosurveillance, Études longitudinales.
Wicri :
- geographic : Afrique du Sud.

English descriptors

KwdEn :
- Adolescent, Adult, Anti-Retroviral Agents (therapeutic use), Child, Epidemiological Monitoring, Female, HIV Infections (drug therapy), HIV Infections (epidemiology), Humans, Longitudinal Studies, Male, Middle Aged, Prevalence, Rural Population, South Africa (epidemiology), Young Adult.
MESH :
- chemical , therapeutic use : Anti-Retroviral Agents.
- geographic , epidemiology : South Africa.
- drug therapy : HIV Infections.
- epidemiology : HIV Infections.
- Adolescent, Adult, Child, Epidemiological Monitoring, Female, Humans, Longitudinal Studies, Male, Middle Aged, Prevalence, Rural Population, Young Adult.

Abstract

Objectives

To investigate HIV prevalence trends in a rural South African community after the scale-up of antiretroviral treatment (ART) in 2004.

Methods

We estimated adult HIV prevalence (ages 15–49 years) using data from a large, longitudinal, population-based HIV surveillance in rural KwaZulu-Natal, South Africa, over the period from 2004 (the year when the public-sector ART scale-up started) through 2011. We control for selection effects due to surveillance non-participation using multiple imputation. We further linked the surveillance data to patient records from the local HIV treatment programme to estimate ART coverage.

Results

ART coverage of all HIV-infected people in this community increased from 0% in 2004 to 31% in 2011. Over the same observation period adult HIV prevalence increased steadily from 21% to 29%. The overall increase in HIV prevalence was largely driven by the prevalence trends in women and men older than 24 years of age, i.e., the age group in which the largest proportions of HIV-infected people received ART.

Conclusions

The observed dramatic rise in adult HIV prevalence can be largely explained by increased survival of HIV-infected people due to ART. This interpretation is supported by the fact that the overall HIV prevalence trend is mostly due to increases in prevalence in older adults, i.e., in the age groups that currently benefit most from the local ART scale-up. Future studies should decompose HIV prevalence trends into HIV incidence and HIV-specific mortality changes to further improve the causal attribution of prevalence increases to treatment success rather than prevention failure.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264533

DOI: 10.1097/QAD.0b013e328362e832
PubMed: 23669155
PubMed Central: 4264533

Affiliations:

Le document en format XML

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<term>Infections à VIH (épidémiologie)</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term>
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<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>HIV Infections</term>
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<term>Adulte</term>
<term>Adulte d'âge moyen</term>
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<term>Femelle</term>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title>
<p id="P1">To investigate HIV prevalence trends in a rural South African community after the scale-up of antiretroviral treatment (ART) in 2004.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We estimated adult HIV prevalence (ages 15–49 years) using data from a large, longitudinal, population-based HIV surveillance in rural KwaZulu-Natal, South Africa, over the period from 2004 (the year when the public-sector ART scale-up started) through 2011. We control for selection effects due to surveillance non-participation using multiple imputation. We further linked the surveillance data to patient records from the local HIV treatment programme to estimate ART coverage.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">ART coverage of all HIV-infected people in this community increased from 0% in 2004 to 31% in 2011. Over the same observation period adult HIV prevalence increased steadily from 21% to 29%. The overall increase in HIV prevalence was largely driven by the prevalence trends in women and men older than 24 years of age, i.e., the age group in which the largest proportions of HIV-infected people received ART.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">The observed dramatic rise in adult HIV prevalence can be largely explained by increased survival of HIV-infected people due to ART. This interpretation is supported by the fact that the overall HIV prevalence trend is mostly due to increases in prevalence in older adults, i.e., in the age groups that currently benefit most from the local ART scale-up. Future studies should decompose HIV prevalence trends into HIV incidence and HIV-specific mortality changes to further improve the causal attribution of prevalence increases to treatment success rather than prevention failure.</p>
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Le SIDA en Afrique subsaharienne (serveur d'exploration)

Dramatic increases in HIV prevalence after scale-up of antiretroviral treatment: a longitudinal population-based HIV surveillance study in rural kwazulu-natal

Dramatic increases in HIV prevalence after scale-up of antiretroviral treatment: a longitudinal population-based HIV surveillance study in rural kwazulu-natal

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki

	Le SIDA en Afrique subsaharienne (serveur d'exploration)
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