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Erschienen in: Current HIV/AIDS Reports 4/2016

17.05.2016 | The Global Epidemic (SH Vermund, Section Editor)

The History of the HIV/AIDS Epidemic in Africa

verfasst von: Joseph Kagaayi, David Serwadda

Erschienen in: Current HIV/AIDS Reports | Ausgabe 4/2016

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Abstract

HIV testing of African immigrants in Belgium showed that HIV existed among Africans by 1983. However, the epidemic was recognized much later in most parts of sub-Saharan Africa (SSA) due to stigma and perceived fear of possible negative consequences to the countries’ economies. This delay had devastating mortality, morbidity, and social consequences. In countries where earlier recognition occurred, political leadership was vital in mounting a response. The response involved establishment of AIDS control programs and research on the HIV epidemiology and candidate preventive interventions. Over time, the number of effective interventions has grown; the game changer being triple antiretroviral therapy (ART). ART has led to a rapid decline in HIV-related morbidity and mortality in addition to prevention of onward HIV transmission. Other effective interventions include safe male circumcision, pre-exposure prophylaxis, and post-exposure prophylaxis. However, since none of these is sufficient by itself, delivering a combination package of these interventions is important for ending the HIV epidemic as a public health threat.
Literatur
1.
Zurück zum Zitat Centers for Disease Control. Kaposi’s sarcoma and Pneumocystis pneumonia among homosexual men—New York City and California. MMWR Morb Mortal Wkly Rep, 1981. 30(25):305–8. Centers for Disease Control. Kaposi’s sarcoma and Pneumocystis pneumonia among homosexual men—New York City and California. MMWR Morb Mortal Wkly Rep, 1981. 30(25):305–8.
2.
Zurück zum Zitat Feremans W et al. Virus-like particles in lymphocytes of seven cases of AIDS in Black Africans. Lancet. 1983;2(8340):52–3.CrossRefPubMed Feremans W et al. Virus-like particles in lymphocytes of seven cases of AIDS in Black Africans. Lancet. 1983;2(8340):52–3.CrossRefPubMed
3.
Zurück zum Zitat Carswell JW, Lloyd G, Howells J. Prevalence of HIV-1 in east African lorry drivers. AIDS. 1989;3(11):759–61.CrossRefPubMed Carswell JW, Lloyd G, Howells J. Prevalence of HIV-1 in east African lorry drivers. AIDS. 1989;3(11):759–61.CrossRefPubMed
4.
Zurück zum Zitat Carswell JW, Lloyd G. Rise in prevalence of HIV antibodies recorded at an antenatal booking clinic in Kampala. Uganda AIDS. 1987;1(3):192–3.PubMed Carswell JW, Lloyd G. Rise in prevalence of HIV antibodies recorded at an antenatal booking clinic in Kampala. Uganda AIDS. 1987;1(3):192–3.PubMed
5.
Zurück zum Zitat Hitchcock B. Clampdown on AIDS information in E. Africa. New Afr. 1986:9–10. Hitchcock B. Clampdown on AIDS information in E. Africa. New Afr. 1986:9–10.
6.
Zurück zum Zitat World Health Organization. Workshop on AIDS in Central Africa. 1985. World Health Organization. Workshop on AIDS in Central Africa. 1985.
7.
Zurück zum Zitat Shilts R. And the band played on : politics, people, and the AIDS epidemic. New York: Penguin; 1988. Shilts R. And the band played on : politics, people, and the AIDS epidemic. New York: Penguin; 1988.
9.
Zurück zum Zitat Hooper E. The river : a journey to the source of HIV and AIDS. 1st ed, Boston, MA: Little, Brown and Co. 1999. Hooper E. The river : a journey to the source of HIV and AIDS. 1st ed, Boston, MA: Little, Brown and Co. 1999.
10.
Zurück zum Zitat Korber B et al. Timing the ancestor of the HIV-1 pandemic strains. Science. 2000;288(5472):1789–96.CrossRefPubMed Korber B et al. Timing the ancestor of the HIV-1 pandemic strains. Science. 2000;288(5472):1789–96.CrossRefPubMed
11.
Zurück zum Zitat Worobey M et al. Origin of AIDS: contaminated polio vaccine theory refuted. Nature. 2004;428(6985):820.CrossRefPubMed Worobey M et al. Origin of AIDS: contaminated polio vaccine theory refuted. Nature. 2004;428(6985):820.CrossRefPubMed
12.
Zurück zum Zitat Plotkin SA. CHAT oral polio vaccine was not the source of human immunodeficiency virus type 1 group M for humans. Clin Infect Dis. 2001;32(7):1068–84.CrossRefPubMed Plotkin SA. CHAT oral polio vaccine was not the source of human immunodeficiency virus type 1 group M for humans. Clin Infect Dis. 2001;32(7):1068–84.CrossRefPubMed
13.
Zurück zum Zitat Green EC et al. Uganda’s HIV prevention success: the role of sexual behavior change and the national response. AIDS Behav. 2006;10(4):335–46. discussion 347–50.CrossRefPubMedPubMedCentral Green EC et al. Uganda’s HIV prevention success: the role of sexual behavior change and the national response. AIDS Behav. 2006;10(4):335–46. discussion 347–50.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Tembo G et al. Bed occupancy due to HIV/AIDS in an urban hospital medical ward in Uganda. AIDS. 1994;8(8):1169–71.CrossRefPubMed Tembo G et al. Bed occupancy due to HIV/AIDS in an urban hospital medical ward in Uganda. AIDS. 1994;8(8):1169–71.CrossRefPubMed
16.
Zurück zum Zitat Lange JM. HIV-related morbidity and mortality in sub-Saharan Africa: opportunities for prevention. AIDS. 1993;7(12):1675–6.CrossRefPubMed Lange JM. HIV-related morbidity and mortality in sub-Saharan Africa: opportunities for prevention. AIDS. 1993;7(12):1675–6.CrossRefPubMed
17.
Zurück zum Zitat Kancheya NG et al. Improved HIV testing coverage after scale-up of antiretroviral therapy programs in urban Zambia: evidence from serial hospital surveillance. Med J Zambia. 2010;37(2):71–7.PubMedPubMedCentral Kancheya NG et al. Improved HIV testing coverage after scale-up of antiretroviral therapy programs in urban Zambia: evidence from serial hospital surveillance. Med J Zambia. 2010;37(2):71–7.PubMedPubMedCentral
18.
Zurück zum Zitat Sewankambo NK et al. Mortality associated with HIV infection in rural Rakai District, Uganda. AIDS. 2000;14(15):2391–400.CrossRefPubMed Sewankambo NK et al. Mortality associated with HIV infection in rural Rakai District, Uganda. AIDS. 2000;14(15):2391–400.CrossRefPubMed
19.
Zurück zum Zitat Nunn AJ et al. Mortality associated with HIV-1 infection over five years in a rural Ugandan population: cohort study. BMJ. 1997;315(7111):767–71.CrossRefPubMedPubMedCentral Nunn AJ et al. Mortality associated with HIV-1 infection over five years in a rural Ugandan population: cohort study. BMJ. 1997;315(7111):767–71.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Borgdorff MW et al. HIV-1 incidence and HIV-1 associated mortality in a cohort of urban factory workers in Tanzania. Genitourin Med. 1995;71(4):212–5.PubMedPubMedCentral Borgdorff MW et al. HIV-1 incidence and HIV-1 associated mortality in a cohort of urban factory workers in Tanzania. Genitourin Med. 1995;71(4):212–5.PubMedPubMedCentral
21.
Zurück zum Zitat Mulder DW et al. HIV-1 incidence and HIV-1-associated mortality in a rural Ugandan population cohort. AIDS. 1994;8(1):87–92.CrossRefPubMed Mulder DW et al. HIV-1 incidence and HIV-1-associated mortality in a rural Ugandan population cohort. AIDS. 1994;8(1):87–92.CrossRefPubMed
22.
Zurück zum Zitat Gregson S, Garnett GP, Anderson RM. Is HIV-1 likely to become a leading cause of adult mortality in sub-Saharan Africa? J Acquir Immune Defic Syndr. 1994;7(8):839–52.PubMed Gregson S, Garnett GP, Anderson RM. Is HIV-1 likely to become a leading cause of adult mortality in sub-Saharan Africa? J Acquir Immune Defic Syndr. 1994;7(8):839–52.PubMed
23.
Zurück zum Zitat Dalen N, Nakitende AJ, Musisi S. “They don’t care what happens to us.” The situation of double orphans heading households in Rakai District, Uganda. BMC Public Health, 2009;9:321. Dalen N, Nakitende AJ, Musisi S. “They don’t care what happens to us.” The situation of double orphans heading households in Rakai District, Uganda. BMC Public Health, 2009;9:321.
24.
Zurück zum Zitat Floyd S et al. The social and economic impact of parental HIV on children in northern Malawi: retrospective population-based cohort study. AIDS Care. 2007;19(6):781–90.CrossRefPubMed Floyd S et al. The social and economic impact of parental HIV on children in northern Malawi: retrospective population-based cohort study. AIDS Care. 2007;19(6):781–90.CrossRefPubMed
25.
Zurück zum Zitat Makumbi FE et al. The incidence and prevalence of orphanhood associated with parental HIV infection: a population-based study in Rakai. Uganda AIDS. 2005;19(15):1669–76.PubMed Makumbi FE et al. The incidence and prevalence of orphanhood associated with parental HIV infection: a population-based study in Rakai. Uganda AIDS. 2005;19(15):1669–76.PubMed
26.
Zurück zum Zitat Kamali A et al. The orphan problem: experience of a sub-Saharan Africa rural population in the AIDS epidemic. AIDS Care. 1996;8(5):509–15.CrossRefPubMed Kamali A et al. The orphan problem: experience of a sub-Saharan Africa rural population in the AIDS epidemic. AIDS Care. 1996;8(5):509–15.CrossRefPubMed
27.
Zurück zum Zitat Collins L et al. Child-headed households in Rakai District, Uganda: a mixed-methods study. Paediatr Int Child Health. 2016;36(1):58–63.CrossRef Collins L et al. Child-headed households in Rakai District, Uganda: a mixed-methods study. Paediatr Int Child Health. 2016;36(1):58–63.CrossRef
28.
Zurück zum Zitat Gray RH et al. Randomized trial of presumptive sexually transmitted disease therapy during pregnancy in Rakai. Uganda Am J Obstet Gynecol. 2001;185(5):1209–17.CrossRefPubMed Gray RH et al. Randomized trial of presumptive sexually transmitted disease therapy during pregnancy in Rakai. Uganda Am J Obstet Gynecol. 2001;185(5):1209–17.CrossRefPubMed
29.
Zurück zum Zitat Guay LA et al. Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: HIVNET 012 randomised trial. Lancet. 1999;354(9181):795–802.CrossRefPubMed Guay LA et al. Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: HIVNET 012 randomised trial. Lancet. 1999;354(9181):795–802.CrossRefPubMed
30.
Zurück zum Zitat Coutsoudis A et al. Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa: a prospective cohort study. South African Vitamin A Study Group. Lancet. 1999;354(9177):471–6.CrossRefPubMed Coutsoudis A et al. Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa: a prospective cohort study. South African Vitamin A Study Group. Lancet. 1999;354(9177):471–6.CrossRefPubMed
31.
Zurück zum Zitat Brahmbhatt H et al. Mortality in HIV-infected and uninfected children of HIV-infected and uninfected mothers in rural Uganda. J Acquir Immune Defic Syndr. 2006;41(4):504–8.CrossRefPubMed Brahmbhatt H et al. Mortality in HIV-infected and uninfected children of HIV-infected and uninfected mothers in rural Uganda. J Acquir Immune Defic Syndr. 2006;41(4):504–8.CrossRefPubMed
32.
Zurück zum Zitat Newell ML et al. Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: a pooled analysis. Lancet. 2004;364(9441):1236–43.CrossRefPubMed Newell ML et al. Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: a pooled analysis. Lancet. 2004;364(9441):1236–43.CrossRefPubMed
33.
Zurück zum Zitat Bobat R et al. Mortality in a cohort of children born to HIV-1 infected women from Durban. South Africa S Afr Med J. 1999;89(6):646–8.PubMed Bobat R et al. Mortality in a cohort of children born to HIV-1 infected women from Durban. South Africa S Afr Med J. 1999;89(6):646–8.PubMed
34.
Zurück zum Zitat Robinson NJ et al. Proportion of HIV infections attributable to other sexually transmitted diseases in a rural Ugandan population: simulation model estimates. Int J Epidemiol. 1997;26(1):180–9.CrossRefPubMed Robinson NJ et al. Proportion of HIV infections attributable to other sexually transmitted diseases in a rural Ugandan population: simulation model estimates. Int J Epidemiol. 1997;26(1):180–9.CrossRefPubMed
35.
Zurück zum Zitat Fennema JS et al. HIV prevalence among clients attending a sexually transmitted diseases clinic in Amsterdam: the potential risk for heterosexual transmission. Genitourin Med. 1993;69(1):23–8.PubMedPubMedCentral Fennema JS et al. HIV prevalence among clients attending a sexually transmitted diseases clinic in Amsterdam: the potential risk for heterosexual transmission. Genitourin Med. 1993;69(1):23–8.PubMedPubMedCentral
36.
Zurück zum Zitat Aral SO. Heterosexual transmission of HIV: the role of other sexually transmitted infections and behavior in its epidemiology prevention and control. Annu Rev Public Health. 1993;14:451–67.CrossRefPubMed Aral SO. Heterosexual transmission of HIV: the role of other sexually transmitted infections and behavior in its epidemiology prevention and control. Annu Rev Public Health. 1993;14:451–67.CrossRefPubMed
37.
Zurück zum Zitat Cameron DW, Padian NS. Sexual transmission of HIV and the epidemiology of other sexually transmitted diseases. AIDS. 1990;4 Suppl 1:S99–103.PubMed Cameron DW, Padian NS. Sexual transmission of HIV and the epidemiology of other sexually transmitted diseases. AIDS. 1990;4 Suppl 1:S99–103.PubMed
38.
39.
Zurück zum Zitat Grosskurth H et al. Impact of improved treatment of sexually transmitted diseases on HIV infection in rural Tanzania: randomised controlled trial. Lancet. 1995;346(8974):530–6.CrossRefPubMed Grosskurth H et al. Impact of improved treatment of sexually transmitted diseases on HIV infection in rural Tanzania: randomised controlled trial. Lancet. 1995;346(8974):530–6.CrossRefPubMed
40.
Zurück zum Zitat Kamali A et al. A community randomized controlled trial to investigate impact of improved STD management and behavioural interventions on HIV incidence in rural Masaka, Uganda: trial design, methods and baseline findings. Trop Med Int Health. 2002;7(12):1053–63.CrossRefPubMed Kamali A et al. A community randomized controlled trial to investigate impact of improved STD management and behavioural interventions on HIV incidence in rural Masaka, Uganda: trial design, methods and baseline findings. Trop Med Int Health. 2002;7(12):1053–63.CrossRefPubMed
41.
Zurück zum Zitat Wawer MJ et al. Control of sexually transmitted diseases for AIDS prevention in Uganda: a randomised community trial. Rakai Project Study Group Lancet. 1999;353(9152):525–35. Wawer MJ et al. Control of sexually transmitted diseases for AIDS prevention in Uganda: a randomised community trial. Rakai Project Study Group Lancet. 1999;353(9152):525–35.
42.
Zurück zum Zitat Denison JA et al. HIV voluntary counseling and testing and behavioral risk reduction in developing countries: a meta-analysis, 1990–2005. AIDS Behav. 2008;12(3):363–73.CrossRefPubMed Denison JA et al. HIV voluntary counseling and testing and behavioral risk reduction in developing countries: a meta-analysis, 1990–2005. AIDS Behav. 2008;12(3):363–73.CrossRefPubMed
43.
Zurück zum Zitat Kennedy CE et al. Provider-initiated HIV testing and counseling in low- and middle-income countries: a systematic review. AIDS Behav. 2013;17(5):1571–90.CrossRefPubMedPubMedCentral Kennedy CE et al. Provider-initiated HIV testing and counseling in low- and middle-income countries: a systematic review. AIDS Behav. 2013;17(5):1571–90.CrossRefPubMedPubMedCentral
44.
Zurück zum Zitat Fonner VA et al. Voluntary counseling and testing (VCT) for changing HIV-related risk behavior in developing countries. Cochrane Database Syst Rev. 2012;9:CD001224.PubMedPubMedCentral Fonner VA et al. Voluntary counseling and testing (VCT) for changing HIV-related risk behavior in developing countries. Cochrane Database Syst Rev. 2012;9:CD001224.PubMedPubMedCentral
45.
Zurück zum Zitat Taha TE et al. Postexposure prophylaxis of breastfeeding HIV-exposed infants with antiretroviral drugs to age 14 weeks: updated efficacy results of the PEPI-Malawi trial. J Acquir Immune Defic Syndr. 2011;57(4):319–25.CrossRefPubMed Taha TE et al. Postexposure prophylaxis of breastfeeding HIV-exposed infants with antiretroviral drugs to age 14 weeks: updated efficacy results of the PEPI-Malawi trial. J Acquir Immune Defic Syndr. 2011;57(4):319–25.CrossRefPubMed
46.
Zurück zum Zitat Fowler MG et al. Efficacy and safety of an extended nevirapine regimen in infants of breastfeeding mothers with HIV-1 infection for prevention of HIV-1 transmission (HPTN 046): 18-month results of a randomized, double-blind, placebo-controlled trial. J Acquir Immune Defic Syndr. 2014;65(3):366–74.CrossRefPubMedPubMedCentral Fowler MG et al. Efficacy and safety of an extended nevirapine regimen in infants of breastfeeding mothers with HIV-1 infection for prevention of HIV-1 transmission (HPTN 046): 18-month results of a randomized, double-blind, placebo-controlled trial. J Acquir Immune Defic Syndr. 2014;65(3):366–74.CrossRefPubMedPubMedCentral
47.
Zurück zum Zitat Coovadia HM et al. Efficacy and safety of an extended nevirapine regimen in infant children of breastfeeding mothers with HIV-1 infection for prevention of postnatal HIV-1 transmission (HPTN 046): a randomised, double-blind, placebo-controlled trial. Lancet. 2012;379(9812):221–8.CrossRefPubMed Coovadia HM et al. Efficacy and safety of an extended nevirapine regimen in infant children of breastfeeding mothers with HIV-1 infection for prevention of postnatal HIV-1 transmission (HPTN 046): a randomised, double-blind, placebo-controlled trial. Lancet. 2012;379(9812):221–8.CrossRefPubMed
48.
Zurück zum Zitat McIntyre JA et al. Efficacy of short-course AZT plus 3TC to reduce nevirapine resistance in the prevention of mother-to-child HIV transmission: a randomized clinical trial. PLoS Med. 2009;6(10):e1000172.CrossRefPubMedPubMedCentral McIntyre JA et al. Efficacy of short-course AZT plus 3TC to reduce nevirapine resistance in the prevention of mother-to-child HIV transmission: a randomized clinical trial. PLoS Med. 2009;6(10):e1000172.CrossRefPubMedPubMedCentral
50.
Zurück zum Zitat Reniers G et al. Mortality trends in the era of antiretroviral therapy: evidence from the Network for Analysing Longitudinal Population based HIV/AIDS data on Africa (ALPHA). AIDS. 2014;28 Suppl 4:S533–42.CrossRefPubMedPubMedCentral Reniers G et al. Mortality trends in the era of antiretroviral therapy: evidence from the Network for Analysing Longitudinal Population based HIV/AIDS data on Africa (ALPHA). AIDS. 2014;28 Suppl 4:S533–42.CrossRefPubMedPubMedCentral
51.
Zurück zum Zitat Floyd S et al. The effect of antiretroviral therapy provision on all-cause, AIDS and non-AIDS mortality at the population level—a comparative analysis of data from four settings in Southern and East Africa. Trop Med Int Health. 2012;17(8):e84–93.CrossRefPubMedPubMedCentral Floyd S et al. The effect of antiretroviral therapy provision on all-cause, AIDS and non-AIDS mortality at the population level—a comparative analysis of data from four settings in Southern and East Africa. Trop Med Int Health. 2012;17(8):e84–93.CrossRefPubMedPubMedCentral
52.
Zurück zum Zitat Mwagomba B et al. Mortality reduction associated with HIV/AIDS care and antiretroviral treatment in rural Malawi: evidence from registers, coffin sales and funerals. PLoS One. 2010;5(5):e10452.CrossRefPubMedPubMedCentral Mwagomba B et al. Mortality reduction associated with HIV/AIDS care and antiretroviral treatment in rural Malawi: evidence from registers, coffin sales and funerals. PLoS One. 2010;5(5):e10452.CrossRefPubMedPubMedCentral
53.
Zurück zum Zitat Hooshyar D et al. Trends in perimortal conditions and mortality rates among HIV-infected patients. AIDS. 2007;21(15):2093–100.CrossRefPubMed Hooshyar D et al. Trends in perimortal conditions and mortality rates among HIV-infected patients. AIDS. 2007;21(15):2093–100.CrossRefPubMed
54.
Zurück zum Zitat April MD et al. The survival benefits of antiretroviral therapy in South Africa. J Infect Dis. 2014;209(4):491–9.CrossRefPubMed April MD et al. The survival benefits of antiretroviral therapy in South Africa. J Infect Dis. 2014;209(4):491–9.CrossRefPubMed
55.
Zurück zum Zitat Bor J et al. Increases in adult life expectancy in rural South Africa: valuing the scale-up of HIV treatment. Science. 2013;339(6122):961–5.CrossRefPubMed Bor J et al. Increases in adult life expectancy in rural South Africa: valuing the scale-up of HIV treatment. Science. 2013;339(6122):961–5.CrossRefPubMed
56.
Zurück zum Zitat Reynolds SJ et al. HIV-1 transmission among HIV-1 discordant couples before and after the introduction of antiretroviral therapy. AIDS. 2011;25(4):473–7.CrossRefPubMedPubMedCentral Reynolds SJ et al. HIV-1 transmission among HIV-1 discordant couples before and after the introduction of antiretroviral therapy. AIDS. 2011;25(4):473–7.CrossRefPubMedPubMedCentral
57.
Zurück zum Zitat Organization W.H. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. 2014 [cited 2016 21/16/2016]. Organization W.H. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. 2014 [cited 2016 21/16/2016].
59.•
Zurück zum Zitat VanDeusen A, et al. Cost effectiveness of option B plus for prevention of mother-to-child transmission of HIV in resource-limited countries: evidence from Kumasi, Ghana. BMC Infect Dis, 2015. 15: p. 130. This publication assessed the cost-effectiveness of option B+ compared to option B for prevention of mother-to-child transmission of HIV and its impact on maternal life expectancy among pregnant and breastfeeding women in Ghana. The results showed that option B+ was associated with a gain of 0.1 maternal QALYs and 3.2 additional QALYs per child, with a cost of $785/QALY gained—a value considered very cost-effective by World Health Organization benchmarks. It also showed that in Ghana, use of option B+ could theoretically prevent up to 668 HIV infections among children annually. These results showed that use of option B+ increased both maternal and pediatric QALYs and was a cost-effective use of limited resources in Ghana. This article provides more evidence of the potential impact of option B+ on HIV vertical transmission, infant, and maternal mortality. VanDeusen A, et al. Cost effectiveness of option B plus for prevention of mother-to-child transmission of HIV in resource-limited countries: evidence from Kumasi, Ghana. BMC Infect Dis, 2015. 15: p. 130. This publication assessed the cost-effectiveness of option B+ compared to option B for prevention of mother-to-child transmission of HIV and its impact on maternal life expectancy among pregnant and breastfeeding women in Ghana. The results showed that option B+ was associated with a gain of 0.1 maternal QALYs and 3.2 additional QALYs per child, with a cost of $785/QALY gained—a value considered very cost-effective by World Health Organization benchmarks. It also showed that in Ghana, use of option B+ could theoretically prevent up to 668 HIV infections among children annually. These results showed that use of option B+ increased both maternal and pediatric QALYs and was a cost-effective use of limited resources in Ghana. This article provides more evidence of the potential impact of option B+ on HIV vertical transmission, infant, and maternal mortality.
60.
Zurück zum Zitat Tweya H, et al. Comparative cost-effectiveness of Option B+ for prevention of mother to child transmission of HIV in Malawi: mathematical modelling study. AIDS, 2015. Tweya H, et al. Comparative cost-effectiveness of Option B+ for prevention of mother to child transmission of HIV in Malawi: mathematical modelling study. AIDS, 2015.
61.
Zurück zum Zitat Fasawe O et al. Cost-effectiveness analysis of Option B+ for HIV prevention and treatment of mothers and children in Malawi. PLoS One. 2013;8(3):e57778.CrossRefPubMedPubMedCentral Fasawe O et al. Cost-effectiveness analysis of Option B+ for HIV prevention and treatment of mothers and children in Malawi. PLoS One. 2013;8(3):e57778.CrossRefPubMedPubMedCentral
62.
Zurück zum Zitat Binagwaho A et al. Prevention of mother-to-child transmission of HIV: cost-effectiveness of antiretroviral regimens and feeding options in Rwanda. PLoS One. 2013;8(2):e54180.CrossRefPubMedPubMedCentral Binagwaho A et al. Prevention of mother-to-child transmission of HIV: cost-effectiveness of antiretroviral regimens and feeding options in Rwanda. PLoS One. 2013;8(2):e54180.CrossRefPubMedPubMedCentral
65.
Zurück zum Zitat Thigpen MC et al. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012;367(5):423–34.CrossRefPubMed Thigpen MC et al. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012;367(5):423–34.CrossRefPubMed
66.
Zurück zum Zitat Auvert B et al. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med. 2005;2(11):e298.CrossRefPubMedPubMedCentral Auvert B et al. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med. 2005;2(11):e298.CrossRefPubMedPubMedCentral
67.
Zurück zum Zitat Bailey RC et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369(9562):643–56.CrossRefPubMed Bailey RC et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369(9562):643–56.CrossRefPubMed
68.
Zurück zum Zitat Gray RH et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369(9562):657–66.CrossRefPubMed Gray RH et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369(9562):657–66.CrossRefPubMed
69.•
Zurück zum Zitat World Health Organization. 10 million men stepped up for HIV prevention. Voluntary medical male circumcision. Infographic. 2015 [cited 2016 Feb 16]; Available from: http://www.who.int/hiv/pub/malecircumcision/vmmc-infographic/en/. This publication highlighted the rapid scale-up of circumcision services in sub-Saharan Africa to more than 10 million in 5 years starting in 2011 as a success story. First, it recognizes the unquestionable effectiveness of male circumcision for HIV prevention; it recognizes that majority of HIV incidence occurs in sub-Saharan Africa; and it finally shows the focus areas for male circumcision in sub-Saharan Africa as being 14 priority countries in eastern and southern Africa which have a high burden of HIV and low prevalence for circumcision. The rapid scale-up of circumcision in these priority countries is evidence that rapid scale-up of this intervention is possible in sub-Saharan Africa and that circumcision offers great promise of its impact on the HIV epidemic in sub-Saharan Africa. World Health Organization. 10 million men stepped up for HIV prevention. Voluntary medical male circumcision. Infographic. 2015 [cited 2016 Feb 16]; Available from: http://​www.​who.​int/​hiv/​pub/​malecircumcision​/​vmmc-infographic/​en/​. This publication highlighted the rapid scale-up of circumcision services in sub-Saharan Africa to more than 10 million in 5 years starting in 2011 as a success story. First, it recognizes the unquestionable effectiveness of male circumcision for HIV prevention; it recognizes that majority of HIV incidence occurs in sub-Saharan Africa; and it finally shows the focus areas for male circumcision in sub-Saharan Africa as being 14 priority countries in eastern and southern Africa which have a high burden of HIV and low prevalence for circumcision. The rapid scale-up of circumcision in these priority countries is evidence that rapid scale-up of this intervention is possible in sub-Saharan Africa and that circumcision offers great promise of its impact on the HIV epidemic in sub-Saharan Africa.
70.•
Zurück zum Zitat UNAIDS. Fast-Tracking combination prevention. 2015 [cited 2016 Feb. 16]; Available from: http://www.unaids.org/en/resources/documents/2015/20151019_JC2766_Fast_tracking_combination_prevention. This UNAIDS publication focuses on the need to reduce new HIV infections globally to fewer than 500,000 by 2020, as a step towards ending the HIV epidemic as a public health threat. It recognizes a great need to fast-track the response through renewed commitment to sustained funding for and scale-up of HIV prevention programs focusing on pockets of high rates of transmission including key populations. The publication also points out the fact that no single intervention, in and of itself, is sufficient to stop the HIV epidemic, and therefore emphasizes the need for combination packages that offer a mix of proven high-impact HIV prevention interventions, as well as the need for adequate scale-up of these interventions. It also emphasizes a need for continued innovation of better technologies for prevention, better program delivery, better integration with other health services, use of new media, as well as better coordination between stakeholders. If adopted, the recommendations in this publication have the potential to rapidly impact the HIV epidemic on the most affected areas. UNAIDS. Fast-Tracking combination prevention. 2015 [cited 2016 Feb. 16]; Available from: http://​www.​unaids.​org/​en/​resources/​documents/​2015/​20151019_​JC2766_​Fast_​tracking_​combination_​prevention. This UNAIDS publication focuses on the need to reduce new HIV infections globally to fewer than 500,000 by 2020, as a step towards ending the HIV epidemic as a public health threat. It recognizes a great need to fast-track the response through renewed commitment to sustained funding for and scale-up of HIV prevention programs focusing on pockets of high rates of transmission including key populations. The publication also points out the fact that no single intervention, in and of itself, is sufficient to stop the HIV epidemic, and therefore emphasizes the need for combination packages that offer a mix of proven high-impact HIV prevention interventions, as well as the need for adequate scale-up of these interventions. It also emphasizes a need for continued innovation of better technologies for prevention, better program delivery, better integration with other health services, use of new media, as well as better coordination between stakeholders. If adopted, the recommendations in this publication have the potential to rapidly impact the HIV epidemic on the most affected areas.
71.•
Zurück zum Zitat Hayes R et al. HPTN 071 (PopART): rationale and design of a cluster-randomised trial of the population impact of an HIV combination prevention intervention including universal testing and treatment—a study protocol for a cluster randomised trial. Trials. 2014;15:57. This paper describes the rationale and design of a trial to compare the population impact of three combination HIV prevention interventions in 21 communities in Zambia and South Africa including intervention 1 consisting of annual home-based HIV testing, promotion of medical male circumcision for HIV-negative men, and universal testing and treatment (UTT); intervention 2 consisting of everything in intervention 1 except that ART initiation will follow current national guidelines, and intervention 3 consisting being standard of care. Population cohorts of 2,500 adults will be randomly selected from each cluster and followed for 3 years to measure HIV incidence. Trial results, combined with modeling and cost data, will be used to assess the cost-effectiveness of UTT interventions. In addition, the three-arm design will enable assessment of how much could be achieved by optimal delivery of current policies and the costs and benefits of extending this to UTT. This trial will inform policies on scale-up of the WHO’s recommendations of test and “start.”.CrossRefPubMedPubMedCentral Hayes R et al. HPTN 071 (PopART): rationale and design of a cluster-randomised trial of the population impact of an HIV combination prevention intervention including universal testing and treatment—a study protocol for a cluster randomised trial. Trials. 2014;15:57. This paper describes the rationale and design of a trial to compare the population impact of three combination HIV prevention interventions in 21 communities in Zambia and South Africa including intervention 1 consisting of annual home-based HIV testing, promotion of medical male circumcision for HIV-negative men, and universal testing and treatment (UTT); intervention 2 consisting of everything in intervention 1 except that ART initiation will follow current national guidelines, and intervention 3 consisting being standard of care. Population cohorts of 2,500 adults will be randomly selected from each cluster and followed for 3 years to measure HIV incidence. Trial results, combined with modeling and cost data, will be used to assess the cost-effectiveness of UTT interventions. In addition, the three-arm design will enable assessment of how much could be achieved by optimal delivery of current policies and the costs and benefits of extending this to UTT. This trial will inform policies on scale-up of the WHO’s recommendations of test and “start.”.CrossRefPubMedPubMedCentral
Metadaten
Titel
The History of the HIV/AIDS Epidemic in Africa
verfasst von
Joseph Kagaayi
David Serwadda
Publikationsdatum
17.05.2016
Verlag
Springer US
Erschienen in
Current HIV/AIDS Reports / Ausgabe 4/2016
Print ISSN: 1548-3568
Elektronische ISSN: 1548-3576
DOI
https://doi.org/10.1007/s11904-016-0318-8

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