With its recommendations that all patients initiate Tenofovir, WHO anticipated improved adherence and reduced lost to follow-up, with implications for long health outcomes such as CD4 recovery, viral suppression and survival. We show that the guideline change replacing Stavudine with Tenofovir in first-line ART improved retention in care and reduced single-drug
We demonstrated that patient-related factors (e.g. use of traditional/herbal medicine, depression, family/social support) but not necessarily provider-related factors, health system factors or treatment related factors contribute to poor adherence on second-line ART. Based on our findings, there is a need for on-going counselling and education of patients on second-line ART. Strategies to support patients, improved adherence evaluation and intensified monitoring need to be considered and
Public clinics in South Africa maintain several paper registers for tracking service provision on a daily basis. These form part of the medico-legal recording requirements at the primary health care level. However, we identified duplication across the registers, and many registered that were not filled out consistently or correctly. If completed properly, there is the potential to use the records to track integration of service delivery. Engaging clinic staff as key role players, including
Currently, there are a limited number of studies focusing specifically on the effects of active ARV drugs administered as separate pills compared to those same active drugs administered in a fixed dose combination. Thus the current study helps fill a critical gap in literature. Our results suggest that under programmatic conditions, FDCs achieve similar outcomes in terms of attrition and virology suppression compared to a multi-pill regimen. However, FDCs may have an important role to play in
Our analyses revealed high prevalence of both hypertension and diabetes and substantial unmet need for care in the South African population. We found that 35% of South Africans aged 15+ have hypertension and 10% have diabetes, and we estimated that 91% of the hypertensive population and 81% of the diabetic population in South Africa have an unmet need for
We found South African adults on ART have increased rates of elevated total cholesterol but tenofovir affects total cholesterol less than do other NRTIs. Older patients and patients with increase BMI are at an increased risk of high cholesterol and should therefore be monitored closely and perhaps be prioritised for cholesterol-lowering drugs, while at the same time receiving lifestyle and dietary
The South African Department of Health (DOH) has decided to replace the antiretroviral therapy (ART) regimen for adults on first line by replacing efavirenz (EFV) with the better tolerated dolutegravir (DTG). We were tasked by DOH to assess the impact of this change on the cost of the national ART
The female condom (FC) was identified by the Reproductive Health Supplies Coalition in 2011 as one of several under-used reproductive health technologies with the potential to expand choice in reproductive health and family planning programs, responding to the needs of diverse clients (1). The FC is also key to increasing HIV protection options for women and men. It is the only female-initiated HIV prevention barrier method. Although FC distribution rates lag far behind those of male condoms
The female condom (FC) was identified by the Reproductive Health Supplies coalition in 2011 as one of several under used reproductive health technologies with the potential to expand choice in reproductive health and family planning programs, responding to the needs of diverse clients. The FC is also key to the increasing HIV protection options for women and men. It is the only female-initiated HIV prevention method. Although FC distribution rates lag far behind those of male condoms, recently
The female condom (FC) was identified by the Reproductive Health Supplies Coalition in 2011 as one of several under-used reproductive health technologies with the potential to expand choice in reproductive health and family planning programs, responding to the needs of diverse clients (1). The FC is also key to increasing HIV protection options for women and men. It is the only female-initiated HIV prevention barrier method. Although FC distribution rates lag far behind those of male condoms
The Validation of Implementation of Cervical Cancer Screening Applications in HIV-Seropositive Women Study (VICAR 1) was conducted in 2009-2011 to compare three methods for detecting cervical cancer: standard Pap smear, visual inspection with acetic acid, and HPV detection. VICAR 1’s main goal was to estimate sensitivity, specificity, and predictive values for each method. VICAR 1 participants, however, also answered an interviewer-administered, structured questionnaire containing coded
Among women, cervical cancer is the second most common cancer globally, with more than half a million new cases and a quarter million deaths from the disease annually . The association between HIV and invasive cervical cancer (ICC) is complex, with several studies demonstrating an increased risk of pre invasive cervical lesions among HIV-positive women . Previous studies have found significantly higher prevalence of human papillomavirus (HPV) infection and of high-risk HPV types in HIV positive
