ArticleProceedings of the National Academy of Sciences of the United States of America2021
Large age shifts in HIV-1 incidence patterns in KwaZulu-Natal, South Africa.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 52 citations in OpenAlex.
- Evaluating the impact of conditional micro-incentives on linkage to HIV care in rural South Africa: results from the Home-Based Intervention to Test and Start (HITS) trial.Health policy and planning · 2026Trial
- Alcohol Use and the Pre-exposure Prophylaxis Continuum of Care Among Men in Rural South Africa: Results from a Longitudinal Study.AIDS and behavior · 2025Trial
- Trial
- Adaptation and Evaluation of a Multi-Component School-Based Sexual Reproductive Health Intervention Safer Choices Programme in Rural KwaZulu-Natal, South Africa - A Process Evaluation.Journal of the International AIDS Society · 2026Article
- Antiretroviral therapy blocks natural selection on protective and disease-susceptible HLA-B alleles in HIV-1 infection.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- Evaluating the biomedical and behavioral drivers of HIV incidence decline in adolescent girls and young women in Uganda: A mathematical modeling study.PLoS medicine · 2026Article
- Linkage of HIV treatment and population-based surveillance records in rural South Africa: the AHRI Unified Data Platform (AUDP).Archives of public health = Archives belges de sante publique · 2026Article
- Developing and pretesting a sexual reproductive health (SRH) school health promotion intervention (Safer Choices program) in rural South Africa: Study Protocol.Wellcome open research · 2026Article
- Left behind? A longitudinal analysis of need for preexposure prophylaxis services among middle-aged and older adults in South Africa.AIDS (London, England) · 2025Article
- Epidemiological Patterns of Genital Ulcer Disease and Human Immunodeficiency Virus Among Public Clinic Attendees in Mthatha, Eastern Cape, South Africa.Diseases (Basel, Switzerland) · 2025Article
- Leveraging Smartphone Mobility Data to Understand HIV Risk Among Rural South African Young Adults: Feasibility Study.JMIR mHealth and uHealth · 2025Article
- Trends in population HIV viral suppression: a longitudinal analysis.AIDS (London, England) · 2025Article
- Delivery models of HIV pre-exposure prophylaxis and their influence on uptake in South Africa: An integrative review.Southern African journal of HIV medicine · 2025Review
- Mortality variability and differentials by age and causes of death in rural South Africa, 1994-2018.BMJ global health · 2024Article
- Evaluation of Treatment Outcomes Among Individuals on Highly Active Antiretroviral Therapy in KwaZulu-Natal, South Africa.AIDS research and treatment · 2024Article
- Longitudinal population-level HIV epidemiologic and genomic surveillance highlights growing gender disparity of HIV transmission in Uganda.Nature microbiology · 2024Article
- Cost-effectiveness of single-visit cervical cancer screening in KwaZulu-Natal, South Africa: a model-based analysis accounting for the HIV epidemic.Frontiers in oncology · 2024Article
- Incident pregnancy and mental health among adolescent girls and young women in rural KwaZulu-Natal, South Africa: an observational cohort study.International journal of adolescence and youth · 2024Article
- Understanding the cost-utility of implementing HIV self-testing with digital-based supports.Frontiers in public health · 2024Article
- Causes of death in people living with HIV: Lessons from five health facilities in Eswatini.Southern African journal of HIV medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 8 institutions in 5 countries.
Funding
Abstract
Recent declines in adult HIV-1 incidence have followed the large-scale expansion of antiretroviral therapy and primary HIV prevention across high-burden communities of sub-Saharan Africa. Mathematical modeling suggests that HIV risk will decline disproportionately in younger adult age-groups as interventions scale, concentrating new HIV infections in those >age 25 over time. Yet, no empirical data exist to support these projections. We conducted a population-based cohort study over a 16-y period (2004 to 2019), spanning the early scale-up of antiretroviral therapy and voluntary medical male circumcision, to estimate changes in the age distribution of HIV incidence in a hyperepidemic region of KwaZulu-Natal, South Africa, where adult HIV incidence has recently declined. Median age of HIV seroconversion increased by 5.5 y in men and 3.0 y in women, and the age of peak HIV incidence increased by 5.0 y in men and 2.0 y in women. Incidence declined disproportionately among young men (64% in men 15 to 19, 68% in men 20 to 24, and 46% in men 25 to 29) and young women (44% in women 15 to 19, 24% in women 20 to 24) comparing periods pre- versus post-universal test and treat. Incidence was stable (<20% change) in women aged 30 to 39 and men aged 30 to 34. Age shifts in incidence occurred after 2012 and were observed earlier in men than in women. These results provide direct epidemiological evidence of the changing demographics of HIV risk in sub-Saharan Africa in the era of large-scale treatment and prevention. More attention is needed to address lagging incidence decline among older individuals.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.