Resource Library

Introduction

People living with HIV (PLWH) are mainly African or Asian, the majority female. In contrast, pharmaceutical companies typically conduct phase 3 regulatory randomised controlled trials (RCTs) in high-income countries (HICs), where PLWH are mainly white males…

Introduction

In South Africa, HIV‐infected men are less likely than women to test and know their status (the first UNAIDS “90‐90‐90” target), and men have worse outcomes across the HIV care cascade. HIV self‐testing (HIVST) may address this testing disparity but…

Person‐centered care through integration of services and engaging clients in their own care is essential to achieving epidemic control of HIV. Verticalization of services along the care continuum contributes to inequities in access to care and leads to stigma and discrimination. Our experience…

The National Strategic Plan for HIV, TB and STIs (NSP) 2017-2022 Mid Term Review (MTR) was an in-depth analysis of the NSP implementation, with the aim to illustrate progress made towards reaching the NSP targets across the eight NSP goals. The review focused on the first half of the NSP term (…

Introduction

South Africa introduced Universal Test and Treat in 2016 including antiretroviral therapy (ART) initiation on the same‐day as HIV diagnosis. Our study sought to evaluate the impact of same‐day ART initiation on loss to follow‐up (LTFU) and…

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…

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…

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…

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…

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…

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…

Update on recommendations on antiretroviral regimens for treating and preventing HIV infection: In 2016, WHO published the consolidated guidelines on the use of antiretroviral (ARV) drugs for treating and preventing HIV infection and recommended tenofovir disoproxil fumarate (…

BACKGROUND: In Malawi's PMTCT Option B+ program, HIV-infected pregnant women who are already receiving ART are continued on…

Background

Initiation of antiretroviral therapy (ART) following diagnosis of HIV infection at birth is an emerging area of paediatric HIV care. We present outcomes of HIV-infected infants identified at birth at Rahima Moosa Mother and Child Hospital in Johannesburg,…

Despite progress in many aspects of the global HIV response, women - particularly adolescent girls and young women - continue to be disproportionately affected by HIV. Women constitute more than half of all people living with HIV. AIDS-related illnesses remain the leading cause of death for…

The purpose of this guide is to provide a resource for clinicians on the ground who manage HIV and TB clients on a daily basis. The guide presents the tools and knowledge required to ensure that clients are offered the best quality of service, and will also enable the health facility to move…

This first volume of the 90-90-90 Compendium is targeted at a wide range of readers in South Africa, including community members and/or politicians with no medical background. It is designed to assist all health sector role-players in understanding the context of the 90-90-90 strategy, as…

Cryptococcal disease is an opportunistic infection that occurs primarily among people with advanced HIV disease and is an important cause of morbidity and mortality in this group. By far the most common presentation of cryptococcal disease is cryptococcal meningitis, which accounts for an…

The Southern African HIV Clinicians Society’s biannual conference, held in Johannesburg, South Africa, from 24-27 October 2018, focused on clinical content for HIV and TB health care workers in the region and featured a wide range of topics…

The Accelerating Children’s HIV/AIDS Treatment (ACT) Initiative was a public-private partnership that expanded pediatric HIV services in nine sub-Saharan African countries from 2014-2016, providing treatment to more than 560,000 children living with HIV. The ACT Initiative was implemented by…