ArticlePloS one2022
Increase in HIV viral suppression in KwaZulu-Natal, South Africa: Community-based cross sectional surveys 2018 and 2013. What remains to be done?
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 22 papers, 2 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Characterizing the HIV care continuum among children and adolescents with HIV in eastern and southern Africa in the era of "Universal Test and Treat": A systematic review and meta-analysis.Journal of the International AIDS Society · 2025Pooled it
- Prevalence and trends of advanced HIV disease among antiretroviral therapy-naïve and antiretroviral therapy-experienced patients in South Africa between 2010-2021: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- 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
- The impact of HIV on cervical cancer elimination in KwaZulu-Natal: a comparative modeling analysis.Journal of the National Cancer Institute · 2026Article
- Prevalence of Frailty and Associated Sociodemographic, Biomedical, and Biochemical Factors Amongst Participants Residing in Limpopo Province, South Africa.Geriatrics (Basel, Switzerland) · 2025Article
- Behavioral HIV-serosurvey reveals clustering of risk factors likely plays a key role in sustaining HIV epidemic in rural KwaZulu-Natal, South Africa.BMC public health · 2025Article
- Trends in population HIV viral suppression: a longitudinal analysis.AIDS (London, England) · 2025Article
- Enhancing tuberculosis (TB) case detection among hospitalized patients through lay health worker led screening: a before-and-after study in KwaZulu-Natal, South Africa.Scientific reports · 2025Article
- Empowerment through knowledge: Qualitative perceptions of 'undetectable equals Untransmittable' among people living with HIV and tuberculosis in South Africa.International journal of nursing studies · 2025Article
- Article
- Integrated multi-month dispensing for HIV and hypertension in South Africa: A model of epidemiological impact and cost-effectiveness.Journal of the International AIDS Society · 2025Article
- Triaging Clients at Risk of Disengagement from HIV Care: Application of a Predictive Model to Clinical Trial Data in South Africa.Risk management and healthcare policy · 2025Article
- Viral load dynamics among adults receiving HIV care in rural North-Eastern South Africa, 2015-2020: insights from a population-based record linkage study.Frontiers in public health · 2025Article
- Article
- Comparative analysis of inflammatory markers in HIV-positive individuals on antiretroviral therapy versus HIV-negative individuals in South Africa.African journal of laboratory medicine · 2025Article
- A risk- and needs-based strategy HIV prevention for adolescent girls and young women, WHO African Region.Bulletin of the World Health Organization · 2024Article
- Article
- Management of Depression in Chronic Care Patients Using a Task-Sharing Approach in a Real-World Primary Health Care Setting in South Africa: Outcomes of a Cohort Study.Community mental health journal · 2023Article
- Evidence of HIV incidence reduction in young women, but not in adolescent girls, in KwaZulu-Natal, South Africa.IJID regions · 2023Article
- Risky sexual behaviors and associated factors among adult patients on antiretroviral treatment at Mankweng Hospital in Limpopo Province, South Africa.Frontiers in public health · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHigh coverage of antiretroviral therapy (ART) in people living with HIV (PLHIV) increases viral suppression at population level and may reduce incidence. Médecins sans Frontières, in collaboration with the South African Department of Health, has been working in Eshowe/Mbongolwane (KwaZulu Natal) since 2011 to increase access to quality HIV services. Five years after an initial survey, we conducted a second survey to measure progress in HIV diagnosis and viral suppression and to identify remaining gaps.
methodsA cross-sectional, population-based, stratified two-stage cluster survey was implemented in 2018, using the same design as in 2013. Consenting participants aged 15-59 years were interviewed and tested for HIV at home. Those HIV-positive were tested for HIV viral load (viral suppression defined as <1000 copies/mL).
resultsOverall, 3,278 individuals were included. The proportion of HIV-positive participants virally suppressed was 83.8% in 2018 compared to 57.1% in 2013 (p<0.001), with increases in all subpopulations. The largest gap remained in men aged 15-29 years, among whom viral suppression was 51.5%. Nevertheless, of the total unsuppressed participants, 60.3% were women, and 57.4% were individuals aged 30-59 years. Between 2013 and 2018, HIV-positive status awareness progressed from 75.2% to 89.9% and ART coverage among those aware from 70.4% to 93.8%, respectively. Among those on ART, 94.5% were virally suppressed in 2018.
conclusionsViral suppression improved significantly from 2013 to 2018, in all age and gender groups of PLHIV. However, almost half of HIV-positive young men remained unsuppressed, while the majority of virally unsuppressed PLHIV were women and older adults. To continue lowering HIV transmission, specific strategies are needed to increase viral suppression in those groups.
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