Southern Africa: the Highest Priority Region for HIV Prevention and Care Interventions

Vermund, Sten H.; Sheldon, Emily K.; Sidat, Mohsin

doi:10.1007/s11904-015-0270-z

Cited by 13 publications

(8 citation statements)

References 38 publications

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“…Southern Africa has the highest HIV prevalence globally with countries such as eSwatini leading with 27.4% [ Figure 3 , (Taha, 2011; Vermund et al, 2015)]. The predominant subtype in the region is HIV-1C (Wilkinson et al, 2015).…”

Section: History Of Hiv In Southern Africamentioning

confidence: 99%

Population Structure and Implications on the Genetic Architecture of HIV-1 Phenotypes Within Southern Africa

Thami

Chimusa

2019

Front. Genet.

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The interesting history of Southern Africa has put the region in the spotlight for population medical genetics. Major events including the Bantu expansion and European colonialism have imprinted unique genetic signatures within autochthonous populations of Southern Africa, this resulting in differential allele frequencies across the region. This genetic structure has potential implications on susceptibility and resistance to infectious diseases such as human immunodeficiency virus (HIV) infection. Southern Africa is the region affected worst by HIV. Here, we discuss advances made in genome-wide association studies (GWAS) of HIV-1 in the past 12 years and dissect population diversity within Southern Africa. Our findings accentuate that a plethora of factors such as migration, language and culture, admixture, and natural selection have profiled the genetics of the people of Southern Africa. Genetic structure has been observed among the Khoe-San, among Bantu speakers, and between the Khoe-San, Coloureds, and Bantu speakers. Moreover, Southern African populations have complex admixture scenarios. Few GWAS of HIV-1 have been conducted in Southern Africa, with only one of these identifying two novel variants (HCG22rs2535307 and CCNG1kgp22385164) significantly associated with HIV-1 acquisition and progression. High genetic diversity, multi-wave genetic mixture and low linkage disequilibrium of Southern African populations constitute a challenge in identifying genetic variants with modest risk or protective effect against HIV-1. We therefore posit that it is compelling to assess genome-wide contribution of ancestry to HIV-1 infection. We further suggest robust methods that can pin-point population-specific variants that may contribute to the control of HIV-1 in Southern Africa.

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Section: History Of Hiv In Southern Africamentioning

confidence: 99%

Population Structure and Implications on the Genetic Architecture of HIV-1 Phenotypes Within Southern Africa

Thami

Chimusa

2019

Front. Genet.

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“…[24] As noted above, Mozambique faces high needs for surveillance information [25] to improve and catalyze prevention and treatment efforts. [26] The country is also located in a region where the availability of trained health care workers is limited. The use of PEs may help to overcome this barrier.…”

Section: Discussionmentioning

confidence: 99%

Effects of a peer educator program for HIV status disclosure and health system strengthening: Findings from a clinic-based disclosure support program in Mozambique

et al. 2020

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Background In Mozambique, HIV counseling and testing (HCT) rates are low and the cascade (or continuum) of care is poor. Perhaps more importantly, low disclosure rates and low uptake of joint testing are also related to both (1) limitations on access to services and (2) the availability of trained staff. We describe the implementation and impact of a disclosure support implemented by peer educators (PE). Methods Ten PEs, previously trained in basic HIV and post-test counseling, completed additional training on providing disclosure support for newly-diagnosed persons living with HIV (PLH). Results Of the 6,092 persons who received HCT, 677 (11.1%) tested positive. Any newly-diagnosed PLH who was tested when PEs were present (606 / 677) was approached about participating in the disclosure program; of these, 94.2% of PLH (n = 574) agreed to participate. Of these, at follow-up (between 1 day and 3 months later, depending on client inclination and availability) 91.9% (n = 528) said that they had disclosed their HIV infection, of whom 66.9% (n = 384) were female and 24.1% (n = 144) male. In turn, 92.7% of partners (n = 508) who had received HIV-related exposure information were tested; of these, 78.7% (n = 400) were found to be HIV-positive. Of the latter, 96.3% (n = 385) were then seen by health care providers and referred for further diagnosis and treatment. Conclusions Supporting newly-diagnosed PLH is important both for their own health and that of others. For the newly-diagnosed, there are extensive challenges related to understanding the implications of their illness; social support from clinical care teams can be vital in planning and

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“…This in particular has been hinged on some causal factors including high prevalence of risky sexual behaviors, rapid urbanization, risky culture such as genital and systemic inflammation, immigration, etc. (Avert, 2017;Vermund, Sheldon and Sidat, 2015;Muula, 2008).…”

Section: Hivmentioning

confidence: 99%

The Burden of Infectious Diseases: A Trend Appraisal in Sub-Saharan Africa Regional Trade Blocs

Jemiluyi

Bank-Ola

2021

JSRMBS

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Purpose: The study aimed at presenting a comparative appraisal of the trends of the two most prevalent infectious diseases bedeviling the region: human immunodeficiency virus (HIV) and tuberculosis (TB). Subject & Methods: Data on fourteen ECOWAS member countries and also fourteen member countries of the SADC bloc. This represents about 93.3% and 87.5% membership of the ECOWAS and SADC blocs respectively. Although the choice of sample size is determined largely by the availability of data, the choices were carefully made to maximize available observation. The data were sourced from World Development Indicators online database published by the World Bank. We use two measures of infectious diseases: the prevalence rate of human immunodeficiency virus and the incidence of tuberculosis. Results: The HIV prevalence rates and incidence of TB were uneven in the two selected trade blocs. The magnitude and the severity of the diseases varied. The burden of both diseases was higher for SADC and lesser for ECOWAS. The average prevalence rate of HIV in the SADC bloc over the study period was 600% of the prevalence rate in ECOWAS (SADC = 12.5%, ECOWAS = 2.1%). Likewise, in the same period, the average TB incidence per 100,000 people was 578.8 and 181.7 respectively in the SADC and ECOWAS blocs. Conclusions: The study finds that the magnitude and severity of the diseases vary widely between the Economic Community of West Africa States (ECOWAS) and the Southern Africa Development Community (SADC) trade blocs. And, while concerted efforts at curbing the diseases have yielded results, there is still much to be done in both blocs.

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Southern Africa: the Highest Priority Region for HIV Prevention and Care Interventions

Cited by 13 publications

References 38 publications

Population Structure and Implications on the Genetic Architecture of HIV-1 Phenotypes Within Southern Africa

Population Structure and Implications on the Genetic Architecture of HIV-1 Phenotypes Within Southern Africa

Effects of a peer educator program for HIV status disclosure and health system strengthening: Findings from a clinic-based disclosure support program in Mozambique

The Burden of Infectious Diseases: A Trend Appraisal in Sub-Saharan Africa Regional Trade Blocs

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