HPTN 052 altered scientific discourse and HIV policy. But has it changed minds? The global scale-up of HIV treatment is one of the greatpublic health success stories of the 21st century. Millions of people with HIV are living longer and healthier lives because of the substantial resources that have been deployed to increase access to medication. Despite widespread awareness of treatment’s therapeutic benefits, however, recent research revealed large global disparities in knowledge about the
Though the DTG-based trial arms were 2% more costly than TDF/FTC/EFV, both had slightly lower cost-per-outcome ($9783 and $9929/patient virally suppressed for TDF/FTCþDTG and TAF/FTCþDTG, respectively) than TDF/FTC/EFV ($10 365). The trial cost per additional virally suppressed patient, compared with TDF/FTC/EFV, was lower in the TDF/FTCþDTG arm ($2967) compared with TAF/FTCþDTG ($3430). In routine care, cost per virally suppressed patient was estimated as similar between TDF/ FTCþDTG
Antiretroviral therapy (ART) nearly eliminates HIV transmission. Yet information on treatment as prevention (TasP) has been slow to diffuse in sub-SaharanAfrica. We assessed TasP knowledge among university students in South Africa. University students in South Africa underestimated the prevention benefits of HIV treatment. Low knowledge of TasP could limit demand for HIVtesting and treatment among young
Objectives: Private managed healthcare organizations in South Africa (SA) use a capitation model of care for patients within their healthcare delivery systems for the optimal management of type 2 diabetes mellitus (T2DM) to reduce healthcare costs. Few studies have categorized healthcare costs at a patient level to determine the actual healthcare costs incurred by private insurers for T2DM in SA. This study estimated the direct medical costs of patients with T2DM registered with a private
Countries around the world have implemented restrictions on mobility, especially cross-border travel to reduce or prevent SARS-CoV-2 community transmission. Rapid antigen testing (Ag-RDT), with on-site administration and rapid turnaround time may provide a valuable screening measure to ease cross-border travel while minimizing risk of local transmission. To maximize impact, we developed an optimal AgRDT screening algorithm for cross-border
Antiretroviral therapy (ART) for human immunodeficiency virus (HIV) prevents illness and death from HIV disease and transmission of HIV infection. To encourage global scale-up of ART, the Joint UN Program on HIV/AIDS (UNAIDS) issued the “95-95-95” targets for the HIV “cascade of care.” These targets state that by 2030, 95% of individuals living with HIV will know their HIV status, 95% of people with diagnosed HIV infection will receive ART, and 95% of those taking ART will have
Epidemiologic methods have advanced tremendously in the last several decades. As important as they are, even the most sophisticated approaches are unable to provide meaningful answers when the user lacks a clear study question. Yet, instructors have more and more resources on how to conduct studies and analyze data but few resources on how to ask clearly defined study questions that will guide those methods. Training programs have limited time for coursework, and if novel statistical estimation
Abstract Background The proposed National Health Insurance (NHI) system aims to re-engineer primary healthcare (PHC) in South Africa, envisioning both private sector providers and public sector clinics as independent contracting units to the NHI Fund. In 2017, 16% of the South African population had private medical insurance and predominately utilised private providers. However, it is estimated that up to 28% of the population access private PHC services, with a meaningful segment of the
ABSTRACT Countries such as South Africa have limited intensive care unit (ICU) capacity to handle the expected number of patients with COVID-19 requiring ICU care. Remdesivir can prevent deaths in countries such as South Africa by decreasing the number of days people spend in ICU, therefore freeing up ICU bed
Abstract People on HIV treatment with an undetectable virus cannot transmit HIV sexually (Undetectable=Untransmittable, U=U). However, the science of treatment-as-prevention (TasP) may not be widely understood by people with and without HIV who could benefit from this information. We systematically reviewed the global literature on knowledge and attitudes related to TasP and interventions providing TasP or U=U information. We included studies of providers, patients, and communities from all
ABSTRACT Background: Following success demonstrated with the HIV Self-Testing Africa Initiative, HIV self-testing (HIVST) is being added to national HIV testing strategies in Southern Africa. An analysis of the costs of scaling up HIVST is needed to inform national plans, but there is a dearth of evidence on methods for forecasting costs at scale from pilot projects. Econometric cost functions (ECFs) apply statistical inference to predict costs; however, we often do not have the luxury of
ABSTRACT Background: HIV self-testing (HIVST) has been shown to be acceptable, feasible and effective in increasing HIV testing uptake. Novel testing strategies are critical to achieving the UNAIDS target of 95% HIV-positive diagnosis by 2025 in South Africa and globally. Methods: We modelled the impact of six HIVST kit distribution modalities (community fixed-point, taxi ranks, workplace, partners of primary healthcare (PHC) antiretroviral therapy (ART) patients), partners of pregnant
