Recent Publications

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 

“I’m living my life now and no longer crying like before”. Implementation lessons from the Common Element Treatment Approach in Gauteng, SA: Targeting vulnerable populations.

Background: One barrier to ART treatment adherence in South Africa is intimate partner violence (IPV), which can also affect mental health. The Common Elements Treatment Approach (CETA) is an evidence-based intervention that simultaneously addresses multiple mental health and other related problems, including IPV that can be delivered by lay-counsellors and adapted to meet an individual’s psychological needs. While the intervention has been shown to be successful in reducing 

Costs associated with Covid-19 hospitalization during the first wave at a tertiary-level hospital in Gauteng, South Africa

BACKGROUND The first wave of COVID-19 infection in South Africa began in March 2020, peaked in July of 2020 and ran until approximately the end of October 2020. Estimates of the cost of COVID-19 care during this period, which was characterized by increasing cases and hospital admissions, are critical for building both health-system resilience and improving responsiveness in future health crises. There is however a dearth of cost estimates for pandemic related hospitalisation in the 

Using Health Technology Assessment to Assist Government Decision-Making Regarding Novel Interventions in South Africa: Applications from PrEP to COVID-19 Therapeutics

Context National Health Insurance (NHI) aims to provide universal healthcare coverage for all Significant step towards achieving equitable healthcare access Health Technology Assessment (HTA) provides critical evidence to support policy and funding decisions Multidisciplinary process to assess the value and impact of health technologies Especially important in the context of NHI Recently developed HTA framework and methods guide aims to assist analysts in preparation for