ArticleSouthern African journal of HIV medicine2017
HIV epidemic drivers in South Africa: A model-based evaluation of factors accounting for inter-provincial differences in HIV prevalence and incidence trends.
Article in Southern African journal of HIV medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Targeting Microorganisms in Lignocellulosic Biomass to Produce Biogas and Ensure Sanitation and Hygiene.Microorganisms · 2026Review
- Preferences of South African Adolescents Living with HIV in the Western Cape Province Regarding the Use of Digital Technology for Self-Management.International journal of environmental research and public health · 2025Article
- The impact of antiretroviral treatment and child-focused unconditional cash transfers on child mortality.SSM - population health · 2024Article
- Evaluation of the impact of PEPFAR transition on retention in care in South Africa's Western Cape Province.South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde · 2023Article
- Evaluation of the impact of PEPFAR transition on retention in care in South Africa's Western Cape.medRxiv : the preprint server for health sciences · 2023Article
- Exploring Determinants of HIV/AIDS Self-Testing Uptake in South Africa Using Generalised Linear Poisson and Geographically Weighted Poisson Regression.Healthcare (Basel, Switzerland) · 2023Article
- Examining differentials in HIV transmission risk behaviour and its associated factors among men in Southern African countries.Humanities & social sciences communications · 2022Article
- Evaluating whole HIV-1 genome sequence for estimation of incidence and migration in a rural South African community.Wellcome open research · 2022Article
- Suicide Prevention in HIV Treatment Centres: Population Attributable Risk Analysis of Treating Common Mental Disorders.AIDS and behavior · 2021Article
- Modelling of HIV prevention and treatment progress in five South African metropolitan districts.Scientific reports · 2021Article
- Effect of HIV Infection and Antiretroviral Treatment on Pregnancy Rates in the Western Cape Province of South Africa.The Journal of infectious diseases · 2020Article
- "My partner was not fond of using condoms and I was not on contraception": understanding adolescent mothers' perspectives of sexual risk behaviour in KwaZulu-Natal, South Africa.BMC public health · 2020Article
- Article
- The geographic distribution of priority population groups for the elimination of mother-to-child transmission of HIV in South Africa.PloS one · 2020Article
- The future of a partially effective HIV vaccine: assessing limitations at the population level.International journal of public health · 2019Article
- Retention in Care Trajectories of HIV-Positive Individuals Participating in a Universal Test-and-Treat Program in Rural South Africa (ANRS 12249 TasP Trial).Journal of acquired immune deficiency syndromes (1999) · 2019Article
- Improving estimates of district HIV prevalence and burden in South Africa using small area estimation techniques.PloS one · 2019Article
- Prevalence & Risk Factors of Post-traumatic Stress Disorder in Patients with Lower Limb Fractures in South Africa.JB & JS open accessArticle
- Barriers to the Implementation of the HIV Universal Test and Treat Strategy in Selected Primary Care Facilities in South Africa's Eastern Cape Province.Journal of primary care & community healthArticle
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Authors and funding
3 authors.
Funding
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Abstract
backgroundHIV prevalence differs substantially between South Africa's provinces, but the factors accounting for this difference are poorly understood.
objectivesTo estimate HIV prevalence and incidence trends by province, and to identify the epidemiological factors that account for most of the variation between provinces.
methodsA mathematical model of the South African HIV epidemic was applied to each of the nine provinces, allowing for provincial differences in demography, sexual behaviour, male circumcision, interventions and epidemic timing. The model was calibrated to HIV prevalence data from antenatal and household surveys using a Bayesian approach. Parameters estimated for each province were substituted into the national model to assess sensitivity to provincial variations.
resultsHIV incidence in 15-49-year-olds peaked between 1997 and 2003 and has since declined steadily. By mid-2013, HIV prevalence in 15-49-year-olds varied between 9.4% (95% CI: 8.5%-10.2%) in Western Cape and 26.8% (95% CI: 25.8%-27.6%) in KwaZulu-Natal. When standardising parameters across provinces, this prevalence was sensitive to provincial differences in the prevalence of male circumcision (range 12.3%-21.4%) and the level of non-marital sexual activity (range 9.5%-24.1%), but not to provincial differences in condom use (range 17.7%-21.2%), sexual mixing (range 15.9%-19.2%), marriage (range 18.2%-19.4%) or assumed HIV prevalence in 1985 (range 17.0%-19.1%).
conclusionThe provinces of South Africa differ in the timing and magnitude of their HIV epidemics. Most of the heterogeneity in HIV prevalence between South Africa's provinces is attributable to differences in the prevalence of male circumcision and the frequency of non-marital sexual activity.
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