Recent Publications

Process indicators to monitor pre-treatment linkage to care and treatment and impact on treatment outcomes among patients diagnosed with rifampicin-resistant tuberculosis in Johannesburg, South Africa.

Background: In 2019 the WHO released “ShORRT”, a generic protocol to evaluate regimens for rifampicin-resistant (RR-) TB. Using process indicators outlined in “ShORRT,” we describe pre-treatment linkage to care and treatment among patients diagnosed with RR-TB in Johannesburg, South 

“I was scared dating. . . who would take me with my status?”—Living with HIV in the era of UTT and U = U: A qualitative study in Johannesburg, South Africa”

Abstract South Africa rolled out Universal Test-and-Treat (UTT) in 2016, extending treatment eligibility to all persons living with HIV (PLHIV). We sought to understand how PLHIV in Johannesburg, South Africa, interpret and experience their HIV status, five years into the UTT era. In May 2021, we conducted in-depth interviews (IDI) (N = 27) with adult (18 years) PLHIV referred by HIV counsellors at three peri-urban primary healthcare clinics. We also conducted three focus group discussions 

A quantitative assessment of the consistency of projections from fve mathematical models of the HIV epidemic in South Africa: a model comparison study

Mathematical models are increasingly used to inform HIV policy and planning. Comparing estimates obtained using different mathematical models can test the robustness of estimates and highlight research gaps. As part of a larger project aiming to determine the optimal allocation of funding for HIV services, in this study we compare projections from five mathematical models of the HIV epidemic in South Africa: EMOD-HIV, Goals, HIV-Synthesis, Optima, and 

Estimating the impact of differentiated models for HIV care

Despite the substantial progress many countries in sub-Saharan Africa have made towards achieving global HIV treatment targets, retaining clients on antiretroviral therapy (ART) after treatment initiation remains a key obstacle to ending the HIV epidemic. In South Africa, disengagement from HIV care during a client's first 12 months after initiation has recently been estimated at approximately 25%;  and only 44% of clients are continuously engaged for the full 12 months, without interruptions. 

Acceptability, feasibility and cost of point of care testing for sexually transmitted infections among South African adolescents where syndromic management is standard of care

Background Young people (YP) in southern Africa are at substantial risk of HIV and sexually transmitted infections (STIs). Despite the epidemiological and biological link between STIs and HIV transmission and acquisition, infections such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) remain widely undiagnosed. Syndromic STI man‑ agement is the standard of care in low- and middle-income countries (LMICs) despite a high prevalence of asymp‑ tomatic infections. We conducted an 

Exploring HIV Risk Factors, Risk Perception, and Risk-Taking among Adolescent Girls and Young Women in Rural South Africa

Adolescent girls and young women (AGYW) face a disproportionately high risk of HIV acquisition, with biological susceptibility, sexual risk behaviours, and structural factors contributing to this vulnerability. Despite these risks, AGYW often perceive themselves as being at low risk of HIV acquisition, which can hinder engagement with HIV prevention services. This study seeks to explore the complex landscape of HIV risk among AGYW in the high HIV-burden setting of uMkhanyakude district, rural 

Preferences for services in a patient’s first six months on antiretroviral therapy for HIV in South Africa and Zambia (PREFER): research protocol for a prospective observational cohort study

Background For patients on HIV treatment in sub-Saharan Africa (SSA), the highest risk for loss from care consistently remains the first six months after antiretroviral (ART) initiation, when patients are not yet eligible for most existing differentiated service delivery (DSD) models. To reduce disengagement from care during this period, we must gain a comprehensive understanding of patients’ needs, concerns, resources, and preferences for service delivery during this period. The PREFER 

Are clients receiving HIV treatment offered a choice of differentiated service delivery models? Evidence from Malawi, South Africa, and Zambia

Background Achieving client-centeredness through differentiated service delivery (DSD) models for HIV treatment includes empowering clients by allowing them to choose the model that best meets their needs. In a survey of the benefits and costs of DSD models for ART, we asked clients enrolled in DSD models in Malawi, South Africa, and Zambia whether they had been offered an opportunity to select their model of 

Adapting research to conduct a Discreet Choice Experiment (DCE) in the context of COVID-19 in Johannesburg, South Africa

Why we did this study The COVID-19 pandemic had unprecedented effects on public health research globally. This affected conventional approaches for collecting primary data. We discuss experiences including ethical implications, challenges and opportunities presented whilst trying to conduct a survey and discreet choice experiment (DCE) under the COVID-19 lockdown