Since 2016, WHO has recommended tenofovir disoproxil fumarate (TDF) + lamivudine (3TC) (or emtricitabine, FTC) + efavirenz (EFV) 600 mg as the preferred first- line antiretroviral therapy (ART) regimen for adults and adolescents. WHO recommended dolutegravir (DTG) as an alternative option to EFV for first-line ART because of the uncertainty regarding the safety and efficacy of DTG during pregnancy and among people living with HIV receiving rifampicin-based tuberculosis (TB) treatment. New WHO interim guidelines contain recommendations regarding preferred first-line regimens for adults, adolescents and children initiating ART, which now include DTG and RAL.
Undetectable = untransmittable is the message of a new UNAIDS Explainer. With 20 years of evidence demonstrating that HIV treatment is highly effective in reducing the transmission of HIV, the evidence is now clear that people living with HIV with an undetectable viral load cannot transmit HIV sexually.
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,
In our fifth issue, we have assembled 70 abstracts published from August through September 2018 that feature evidence from Botswana (3), Eswatini (5), Lesotho (2), Malawi (8), Mozambique (3), Namibia (3), South Africa (40), Tanzania (1), Zambia (12) and Zimbabwe (9).
Through the many presentations, activities and events during the three days of the 2nd International Workshop on HIV Adolescence: Challenges and Solutions, the emphasis on youth involvement was highlighted consistently. It is through this lens that SHARE staff reflect on thoughts from youth participants before its closing.
Looking at where we have come from, and where we are in southern Africa’s fight against HIV, it is clear that we have had some monumental successes and some incredible failures along the way, both of which we can learn from to do better. One clear theme throughout the first day of the 2nd International Workshop on HIV Adolescence: Challenges and Solutions was that we have not consistently and adequately gained the insights of the very people who are enrolled in studies to generate evidence on how to address the needs of these populations. Further, we have not committed the resources required to conduct the research on the populations that are difficult to reach, whether due to challenging ethical enrolment or stigma and criminalization of key populations.
Despite the fact that people under the age of 18 make up about 25% of the global population, research among adolescents has been a neglected area. We know that it is important to conduct research among pediatric and adolescent populations, but to date the focus has remained on adults. Just how significant the risks are of not including adolescents in clinical trials emerged as a key theme at the 2nd International Workshop on HIV Adolescence, as well as the logistical, ethical, legal, justice, and human rights considerations that need to be taken into account when designing and implementing research involving adolescents.
Children and adolescents have poorer HIV treatment outcomes than adults. We aimed to assess the effect of community-based support for caregivers of HIV-infected children and adolescents, who are key mediators to children engaging with care, on treatment outcomes.