PRETORIA, South-Africa, April 10, 2014/African Press Organization (APO)/ — During a two-day consultation, HIV surveillance experts in South Africa agreed that the large scale AIDS response in South Africa has resulted in significant gains. The country made remarkable progress in expanding access to antiretroviral treatment that increased life expectancy amongst people living with HIV and massive declines in the rate of mother-to-child HIV transmission. However, the experts agreed on the need to further expand and intensify current efforts to reduce the impact of AIDS.
Acknowledging the complex nature of the HIV epidemic in South Africa, participants noted the need to effectively deal with social and structural issues that increase vulnerability to HIV and TB infection and hinder access and uptake of HIV services. The experts also agreed that combination prevention – biomedical and behavioural interventions – and expansion of antiretroviral treatment programme is necessary to reverse the epidemic in South Africa. They also stressed the importance of empowering women to reduce their risk of HIV infection; ensuring individual’s comprehensive and accurate understanding of HIV and adherence to treatment; scaling up of HIV counselling and testing (HCT) and creating linkages to HIV treatment and care services; voluntary medical male circumcision; as well as distribution and consistent use of condoms, to decreasing the levels of new infections in the country.
With regard to the prevalence and incidence of HIV there was agreement on the following:
• Overall, the HIV prevalence – the proportion of individuals in a population who are living with HIV annually – has increased. This reflects South Africa’s success in expanding antiretroviral coverage, resulting in people living with HIV to live longer which increases the HIV prevalence in the country – increase in prevalence is clearly seen in adults aged 34 years and older. With 2.6 million people accessing antiretroviral treatment in 2012, South Africa currently has the largest antiretroviral treatment programme in the world. This rapid scale-up of the national antiretroviral treatment programme has also resulted in a stable HIV
prevalence among women attending antenatal clinics.
• In the younger age groups (15 to 24 years) prevalence has decreased due to declining new infections. Successful implementation of the prevention of mother-to-child transmission (PMTCT) programme has led to massive declines in children acquiring HIV infection during pregnancy and childbirth. This success must be celebrated and sustained. Overall, less than 3% of infants of mothers living with HIV are born with HIV. These transmission rates were measured at six weeks after delivery and the results of the on-going Medical Research Council PMTCT evaluation will provide further details on mother-to-child transmission rates at 9 and 18 months.
• New HIV infections – the estimated total number of new (diagnosed and undiagnosed) cases – in the total population are still high. However, there is an indication that new HIV infections are declining in young people aged 15 – 24 years, although these still remain high in adults aged 25 years and older. The experts agreed on the need to analyse drivers of new infections to better understand, prioritise and develop targeted interventions.
• The experts reiterated their commitment in supporting the government to fully understand the HIV epidemic in relation to incidence in particular and committed to work together to this end.
The consultation meeting which was held over two days (April 7-8) was jointly hosted by the Joint United Nations Programme on HIV/AIDS (UNAIDS), the National Institute for Communicable Diseases (NICD/NHLS) and the National Department of Health.
The experts were drawn from various institutions including the Africa Centre for Health and Population Studies, Centre for the AIDS programme of research in South Africa (CAPRISA), U.S. Centers for Disease Control and Prevention (CDC), the HIV Modelling Consortium, Health and Development Africa, Wits Health Consortium Health Economics and Epidemiology Research (HE2RO), Human Sciences Research Council (HSRC), Medical Research Council (MRC), Public Health England, National Department of Health, NICD/NHLS, South African Centre for Epidemiological Modelling and Analysis (SACEMA), South Africa National AIDS Council (SANAC), Statistics South Africa, Wits Reproductive Health and HIV Institute (WHRI), UNAIDS, United Nations Children’s Fund (UNICEF), University of Cape Town Center for Infectious Diseases and Epidemiology Research and the World Health Organization (WHO).
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