Individual and Population Level Impact of Key HIV Risk Factors on HIV Incidence Rates in Durban, South Africa

Ramjee, Gita; Moonsamy, Suri; Abbai, Nathlee; Wand, Handan

doi:10.1371/journal.pone.0153969

Cited by 23 publications

(19 citation statements)

References 38 publications

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“…The incidence of HIV in South Africa is highest among young women below age 25. [24][25][26] The majority (61.9%) of participants in our study had not completed high school. Experience of food insecurity was higher among participants who had not completed high school compared to those who had completed high school (42.4% versus 24.0%, respectively).…”

Section: Discussionmentioning

confidence: 99%

Food insecurity, HIV status and prior testing at South African primary healthcare clinics

Nyirenda¹,

Street²,

Reddy³

et al. 2018

S. Afr. J. Sci.

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HIV and food insecurity are two prominent causes of morbidity and mortality in sub-Saharan Africa. Food insecurity has been associated with risky sexual practices and poor access to healthcare services. We describe the association between household food insecurity and previous HIV testing and HIV status. We used logistic regression to analyse the association between food insecurity and prior HIV counselling and testing (HCT) and testing HIV positive. A total of 2742 adults who presented for HCT at three primary healthcare clinics in KwaZulu-Natal, South Africa, participated in the study. The prevalence of household food insecurity was 35%. The prevalence of food insecurity was highest in adults who had incomplete high schooling (43%), were unemployed (39%), and whose primary source of income was government grants (50%). Individuals who were food insecure had significantly higher odds of testing HIV positive (adjusted odds ratio 1.41, 95% CI 1.16–1.71), adjusted for demographic and socio-economic variables. There was no association between food insecurity and prior HCT. The findings of this study highlight the important role food insecurity may play in HIV risk. Interventions to turn food-insecure into food-secure households are needed to reduce their household members’ vulnerability to HIV acquisition. The absence of such interventions is likely to severely impact ambitious global targets of ending AIDS by 2030 through the 90-90-90 targets and test-and-treat-all initiatives.

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Section: Discussionmentioning

confidence: 99%

Food insecurity, HIV status and prior testing at South African primary healthcare clinics

Nyirenda¹,

Street²,

Reddy³

et al. 2018

S. Afr. J. Sci.

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“…This may influence the rapid onset of cervical disease and further effects on clinical outcome. However, the direct mechanism is not clear (45)(46)(47). Additionally, the effects of duration of HAART use in cervical carcinogenesis prevention are still unknown (48,49).…”

Section: I) Cervical Cancer Pathogenesis Haart and Hiv/hpv Co-infectionmentioning

confidence: 99%

Impact of Host Molecular Genetic Variations and HIV/HPV Co-infection on Cervical Cancer Progression: A Systematic review

Chambuso¹,

Gray²,

Kaambo³

et al. 2018

Oncomedicine

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Only a small subset of women who are co-infected with Human Immunodeficiency Virus sub-type 1 (HIV) and persistence oncogenic Human papillomavirus (HPV), progress rapidly to invasive cervical cancer by mechanisms that are currently poorly understood. The use of Highly Active Antiretroviral Therapy (HAART), with ensuing immune reconstitution of CD4 T-cells, does not appear to prevent rapidly progressing cervical carcinogenesis. Therefore, to better understand the cervical cancer pathogenesis in HIV/HPV co-infected women, this review focuses on identifying host molecular genetic variations and genetic alterations in cervical cancer progression that may play a role in disease progression. This is an important aspect for individualised genomic profiling and targeted molecular prevention in order to improve the management of the disease in this sub-population.

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“…High human immunodeficiency virus (HIV) transmission rates persist as a global challenge [1] and women remain more vulnerable than men to acquire HIV infection [2]. Women's increased vulnerability to HIV infection is multifactorial and encompasses biological, structural, and behavioral factors like being in sexual partnerships with highrisk older men [3], concurrent relationships [4,5], and low condom use due to inability to negotiate safer sex [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…As we approach the fourth decade with HIV, a plethora of prevention interventions have been tried. The persistently high-rate of HIV infections in particular age groups like adolescents [2,[15][16][17], however, suggests prevention of new infections among women remains poorly understood and current interventions are simply not working.…”

Section: Introductionmentioning

confidence: 99%

Cohort effects on sexual behavior and risk of acquisition of sexually transmitted infections and HIV in a South African HIV prevention trial

Nyirenda¹,

Wand²,

Ramjee³

2018

HIV & AIDS Review

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Introduction: As we approach the fourth decade with human immunodeficiency virus (HIV), a plethora of prevention interventions have been tried; however, prevention of new infections among women remain poorly understood and current behavioral change interventions are simply not working. Material and methods: We investigate whether women's sexual behavior risks vary by age cohort, and the effect of this on HIV and sexually transmitted infections (STI) incidence of women enrolled in the South African Carraguard HIV prevention trial, using Cox proportional hazard models. Results: Relative to women born in the 1960s or earlier, HIV incidence was approximately twice as high compared to women born in the 1970s (adjusted hazard rate [aHR]: 1.91; 95% confidence interval [CI]: 1.04-3.48; p < 0.001). Women in the youngest 1980s cohort had the highest risk of HIV infection (aHR: 3.77; 95% CI: 2.25-6.32; p < 0.001). Similarly, women in the 1980s relative to the oldest (≤ 1960s) cohort had significantly higher hazards of acquiring STIs (aHR: 1.51; 95% CI: 1.16-1.96; p = 0.002), had a higher frequency of partner changes, higher coital frequency, higher proportion having had sex for money, to have an older partner, and less likely to have a circumcised partner. Conclusions: Our findings show HIV and STIs incidence remains highest amongst younger compared to older age cohorts, despite decades of STI/HIV risk-reduction interventions. Research is urgently needed to understand why after so many decades of socio-behavioral interventions little appears to have changed in the behavior of young women; instead, there appears to even be a glamorization of risky behaviors such as having older male sexual partners commonly called 'blessers' .

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Individual and Population Level Impact of Key HIV Risk Factors on HIV Incidence Rates in Durban, South Africa

Cited by 23 publications

References 38 publications

Food insecurity, HIV status and prior testing at South African primary healthcare clinics

Food insecurity, HIV status and prior testing at South African primary healthcare clinics

Impact of Host Molecular Genetic Variations and HIV/HPV Co-infection on Cervical Cancer Progression: A Systematic review

Cohort effects on sexual behavior and risk of acquisition of sexually transmitted infections and HIV in a South African HIV prevention trial

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