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High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa

High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa
High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa
The landmark HIV Prevention Trials Network (HPTN) 052 trial in HIV-discordant couples demonstrated unequivocally that treatment with antiretroviral therapy (ART) substantially lowers the probability of HIV transmission to the HIV-uninfected partner. However, it has been vigorously debated whether substantial population-level reductions in the rate of new HIV infections could be achieved in "real-world" sub-Saharan African settings where stable, cohabiting couples are often not the norm and where considerable operational challenges exist to the successful and sustainable delivery of treatment and care to large numbers of patients. We used data from one of Africa's largest population-based prospective cohort studies (in rural KwaZulu-Natal, South Africa) to follow up a total of 16,667 individuals who were HIV-uninfected at baseline, observing individual HIV seroconversions over the period 2004 to 2011. Holding other key HIV risk factors constant, individual HIV acquisition risk declined significantly with increasing ART coverage in the surrounding local community. For example, an HIV-uninfected individual living in a community with high ART coverage (30 to 40% of all HIV-infected individuals on ART) was 38% less likely to acquire HIV than someone living in a community where ART coverage was low (<10% of all HIV-infected individuals on ART).
0036-8075
966-971
Tanser, Frank
a7112c48-809b-4f7c-8662-eaef445891f4
Barnighausen, Till
f99001d2-60f1-4447-b554-b01dca4b4c5e
Grapsa, Erofili
46998c2d-9d43-45e4-b83c-f3a7930c05f5
Zaidi, Jaffer
89b8e5fe-1913-44e4-8031-42e1196d8d46
Newell, Marie-Louise
c6ff99dd-c23b-4fef-a846-a221fe2522b3
Tanser, Frank
a7112c48-809b-4f7c-8662-eaef445891f4
Barnighausen, Till
f99001d2-60f1-4447-b554-b01dca4b4c5e
Grapsa, Erofili
46998c2d-9d43-45e4-b83c-f3a7930c05f5
Zaidi, Jaffer
89b8e5fe-1913-44e4-8031-42e1196d8d46
Newell, Marie-Louise
c6ff99dd-c23b-4fef-a846-a221fe2522b3

Tanser, Frank, Barnighausen, Till, Grapsa, Erofili, Zaidi, Jaffer and Newell, Marie-Louise (2013) High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa. Science, 339 (6122), 966-971. (doi:10.1126/science.1228160). (PMID:23430656)

Record type: Article

Abstract

The landmark HIV Prevention Trials Network (HPTN) 052 trial in HIV-discordant couples demonstrated unequivocally that treatment with antiretroviral therapy (ART) substantially lowers the probability of HIV transmission to the HIV-uninfected partner. However, it has been vigorously debated whether substantial population-level reductions in the rate of new HIV infections could be achieved in "real-world" sub-Saharan African settings where stable, cohabiting couples are often not the norm and where considerable operational challenges exist to the successful and sustainable delivery of treatment and care to large numbers of patients. We used data from one of Africa's largest population-based prospective cohort studies (in rural KwaZulu-Natal, South Africa) to follow up a total of 16,667 individuals who were HIV-uninfected at baseline, observing individual HIV seroconversions over the period 2004 to 2011. Holding other key HIV risk factors constant, individual HIV acquisition risk declined significantly with increasing ART coverage in the surrounding local community. For example, an HIV-uninfected individual living in a community with high ART coverage (30 to 40% of all HIV-infected individuals on ART) was 38% less likely to acquire HIV than someone living in a community where ART coverage was low (<10% of all HIV-infected individuals on ART).

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More information

Published date: 22 February 2013
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 350618
URI: http://eprints.soton.ac.uk/id/eprint/350618
ISSN: 0036-8075
PURE UUID: 03c2051a-75cf-4cd4-8a0e-2b25fa054644
ORCID for Marie-Louise Newell: ORCID iD orcid.org/0000-0002-1074-7699

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Date deposited: 27 Mar 2013 11:58
Last modified: 29 Mar 2023 01:47

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Contributors

Author: Frank Tanser
Author: Till Barnighausen
Author: Erofili Grapsa
Author: Jaffer Zaidi

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