HIV prevalence and incidence studies

Results of a pivotal clinical trial among 7,829 women ages 16-35 in East and Southern Africa provide important evidence to help inform women’s choices for contraception and HIV prevention. The Evidence for Contraceptive Options and HIV Outcomes (ECHO) Study found no substantial difference in HIV risk among women using the three methods of contraception in the study – the copper-releasing intrauterine device (Cu-IUD), a levonorgestrel (LNG) implant (Jadelle) and depot medroxyprogesterone acetate-intramuscular (DMPA-IM), also known as Depo-Provera.

Injectable, intrauterine, and implantable contraceptives have been prioritised for programmatic delivery because of high contraceptive efficacy and safety. Robust evidence on the relative risks, particularly HIV susceptibility, and benefits of these contraceptive methods is important to inform women's decision making, provider counselling, and policy maker and regulatory decisions. Our primary objective was to compare HIV incidence among women using DMPA-IM, a copper IUD, or a levonorgestrel (LNG) implant.

The focus of HIV interventions in Botswana, a country with the second highest prevalence of HIV in the world, remains targeted at those aged 15-49 years despite a growing cohort of older people living with the disease - driven largely by the successful roll-out of antiretroviral therapy (ART). Primarily utilising the Botswana AIDS Impact Survey IV, we set out to examine HIV related characteristics and behaviours of this often ignored older cohort (50-64 years) relative to younger (25-49 years) adults.

The effect of intervention on HIV prevalence in the baseline schoolgirls was sensitive to the model choice; however, HSV-2 prevalence results were confirmed. We recommend that the results from the original published analysis indicating the impact of cash transfers on HIV prevalence be treated with caution.

Data relating to the role that Human immunodeficiency virus (HIV) contributes towards seizures in HIV-infected children is limited. The management of seizures in this group is complex due to potential interactions between antiseizure medication and antiretroviral therapies. This study explores the seizure semiology and course of a population of affected children based on questions raised from a previous epidemiological study.

Young female sex-workers (FSW) aged 18-24 are at high risk of HIV due to high numbers of sexual partners, difficulty negotiating condom use, increased risk of gender-based violence, and limited access to services. Here we describe changes in sexual behaviours among young FSW across Zimbabwe between 2013 and 2016, and risk factors for prevalent HIV in 2013 and 2016.

HIV-positive men have a high burden of genital HPV infection and AGW. ART and HPV vaccine could reduce this burden.

Zimbabwe has made substantial progress towards the Joint United Nations Programme on HIV/AIDS (UNAIDS) targets of 90-90-90 by 2020, with 73% of people living with HIV diagnosed, 87% of those diagnosed on antiretroviral therapy (ART) and 86% of those on ART virally suppressed. Despite this exceptional response, more effort is needed to completely achieve the UNAIDS targets. Here, we conducted a detailed spatial analysis of the geographical structure of the HIV epidemic in Zimbabwe to include geographical prioritization as a key component of their overall HIV intervention strategy.