Resource Library

This publication marks the 25th anniversary of the Beijing Declaration and Platform for Action. It is dedicated to the women leaders and allied community mobilizers who have devoted their lives to advancing the human rights and dignity of all people affected by the HIV epidemic, and to opposing…

Background: Stakeholders question whether implementation science (IS) is successful in conducting rigorous science that expedites the inclusion of health innovations into policies and accelerates the pace and scale of health service delivery into clinical and public health…

BACKGROUND: Most countries have formally adopted the World Health Organization's 2015 recommendation of universal HIV treatment ("treat all"). However, there are few rigorous assessments of the real-world impact of treat all policies on antiretroviral treatment (ART…

Increasing numbers of people living with HIV (PLHIV) in sub-Saharan Africa are experiencing failure of first-line antiretroviral therapy and transitioning onto second-line regimens. However, there is a dearth of research on their treatment experiences. We conducted in-…

In 2017, tuberculosis caused an estimated 1·6 million deaths, including 300 000 deaths among people with HIV, and surpassed HIV/AIDS to become the leading infectious cause of mortality worldwide. Approximately 36% of tuberculosis cases each year (around 3·5 million cases) are not diagnosed or…

Botswana has among the highest level of HIV viral suppression globally, yet HIV incidence remains > 1% per year in adults aged 15 to 49. Although causes of this continued elevated incidence have been postulated, a firm understanding remains elusive, especially in the presence of a highly…

The Southern African Development Community (SADC) is a region associated with both high rates of population mobility – mostly associated with movement within and across national borders to access improved livelihood opportunities – and a high prevalence of communicable diseases, notably HIV and…

BACKGROUND: Expanded HIV prevention options are needed to increase uptake of HIV prevention among women, especially in generalized epidemics. As the dapivirine vaginal ring moves forward through regulatory review and open-label extension studies, the potential public health…

As South Africa seeks to implement national policies on school-based health education and services it is important that the evidence and experiences of existing school health programs be accessible to service providers and role-players. It is for this reason that Médecins Sans Frontières/Doctors…

With only a year until 2020 – and the deadline to reach the 90-90-90 targets – South Africa is dangerously off track. Currently 7.1 million people are living with HIV in the country. New HIV infections remain high, according to the Thembisa model1 at 275 000 in 2017, higher than the 231 000…

More adolescents and young adults living with HIV are surviving into adulthood. As a result they must transition from pediatric health services to HIV self-management and adult care. This change is particularly important as many young people have poor adherence to treatment, leading to low rates…

INTRODUCTION: Since June 2016, the national HIV programme in Malawi has adopted Universal Test and Treat (UTT) guidelines requiring that all persons who test HIV positive will be referred to start antiretroviral therapy (ART). Although there is strong evidence from clinical…

Increasing numbers of people living with HIV (PLHIV) in sub-Saharan Africa are experiencing failure of first-line antiretroviral therapy and transitioning onto second-line regimens. However, there is a dearth of research on their treatment experiences. We conducted in-depth interviews with 43…

Despite public health interventions targeting sex workers in an attempt to increase condom use, HIV still remains a significant health issue for those involved in the sex industry in many countries. In this paper, we analyse data collected as part of an ethnographic study of sex work in Soweto,…

There has been a proliferation of organizations in Zambia touting the mobilization of traditional games as a tool to prevent HIV. However, there is a dearth of evidence on how culturally important activities like traditional games are being incorporated into programing. The purpose of this study…

Despite the rising burden of noncommunicable diseases, access to quality decentralized noncommunicable disease services remain limited in many low- and middle-income countries. Here we describe the strategies we employed to drive the process from adaptation to national endorsement and…

BACKGROUND: Current policy in South Africa requires measurement of blood pressure at every visit in primary care. The number of patients regularly visiting primary care clinics for routine care is increasing rapidly, causing long queues, and unmanageable workloads.

In East and Southern Africa, where 5% to 10% have chronic hepatitis B virus (HBV) infection, incidence of human immunodeficiency virus (HIV) infection remains unacceptably high. This introduces challenges and opportunities for implementation of HBV care and treatment. We now describe new HIV…

BACKGROUND: The GeneXpert MTB/RIF Assay (Xpert(R)) is known to be a feasible, effective and a hopeful tool for rapid tuberculosis (TB) diagnosis and treatment. However, little is known about the time delay caused by initial negative sputum smear microscopy (NSSM), but…

BACKGROUND: Subclinical tuberculosis is an asymptomatic disease phase with important relevance to persons living with HIV. We describe the prevalence, clinical characteristics, and risk of mortality for HIV-infected adults with subclinical tuberculosis.

METHODS…

BACKGROUND: Xpert MTB/RIF, the most widely used automated nucleic acid amplification test for tuberculosis, is available in more than 130 countries. Although diagnostic accuracy is well documented, anticipated improvements in patient outcomes have not been clearly identified. We…

Rural communities comprise about 40% of the country’s population of 57.8 million but, historically, these areas are the last to be considered when it comes to health provision by national, provincial and local authorities. The Protecting Healthcare in Times of Economic Crisis Report…

Background: Drug resistance is a challenge for the global control of tuberculosis. We examined mortality in patients with tuberculosis from high-burden countries, according to concordance or discordance of results from drug susceptibility testing done locally and in a reference…

The cascade of care is a model for evaluating patient retention across sequential stages of care required to achieve a successful treatment outcome. This approach was first used to evaluate HIV care and has since been applied to other diseases. The tuberculosis (TB) community has only recently…

The emergence and expansion of the multidrug-resistant tuberculosis epidemic is a threat to the global control of tuberculosis. Multidrug-resistant tuberculosis is the result of the selection of resistance-conferring mutations during inadequate antituberculosis treatment. However, HIV has a…

One policy reform aimed at maintaining the critical role of civil society in the HIV response in concert with domestic resource mobilization efforts is the development of government-led mechanisms to finance civil society through formalized contractual channels. Such partnerships between…

Introduction: Treatment success rates of rifampicin resistant (RR)/multi-drug resistant (MDR) tuberculosis (TB) in South Africa range from 43–48%, falling short of the World Health Organization’s target of ≥75%. We present rates and assess predictors of attrition by 12 months on…

Objective: We describe baseline characteristics, time to treatment initiation and interim patient outcomes at a decentralized, outpatient treatment site for rifampicin-resistant TB (RR-TB).

Methods: Prospective observational cohort study of RR-TB…