ArticleBMC public health2023
Assessing sex differences in viral load suppression and reported deaths using routinely collected program data from PEPFAR-supported countries in sub-Saharan Africa.
Article in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Virologic failure and its determinants among HIV patients progress towards the third 95% global target in Ethiopia: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- Population Viral Load Suppression and Associated Factors in Tanzania: Findings From 2 Sequential Tanzania HIV Impact Surveys of 2016-2017 and 2022-2023.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Factors Associated with Virological Non-Suppression Among People Living with HIV Receiving Antiretroviral Therapy in Kazakhstan: A National Registry-Based Study.Tropical medicine and infectious disease · 2026Article
- Hypertension is a marker of the micro-epidemiologic transition in ageing HIV populations in Kenya, Uganda and Tanzania (AFRICOS, 2013-2023).BMC public health · 2026Article
- Pre-conflict prescription patterns and virological effectiveness of combination antiretroviral therapy (cART) in HIV-1 patients in Tigray, Ethiopia.AIDS research and therapy · 2026Article
- Factors Associated With Viral Load Suppression Among Adolescents and Young Adults Living With HIV on ART in Rwanda: Data From Rwanda HIV Case-Based Surveillance, 2019-2025.Journal of tropical medicine · 2026Article
- Alcohol use and optimal chronic diseases' treatment outcomes among adults aged 40 years and above in rural South Africa.Scientific reports · 2025Article
- Trends in body mass index for people with and without HIV: Pooled analysis of nationally-representative health surveys from 10 countries and 173,800 adults in Africa.PLOS global public health · 2024Article
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Authors and funding
9 authors at 4 institutions in 4 countries.
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Abstract
backgroundIn sub-Saharan Africa, more women than men access HIV testing and treatment and may have better viral load suppression (VLS). We utilized routinely reported aggregated HIV program data from 21 sub-Saharan African countries to examine sex differences in VLS and death rates within antiretroviral therapy (ART) programs supported by the United States President's Emergency Plan for AIDS Relief (PEPFAR).
methodsWe included VLS and reported death data for persons aged 15 + years on ART from October-December 2020 disaggregated by sex and age for each subnational unit (SNU). We used linear mixed-model regression to estimate VLS proportion and negative binomial mixed-model regression to estimate the rates of death and death plus interruptions in treatment (IIT). All models were weighted for SNU-level ART population size and adjusted for sex, age, HIV/tuberculosis coinfection, country, and SNU; models for reported deaths and deaths plus IIT were also adjusted for SNU-level VLS.
resultsMean VLS proportion was higher among women than men (93.0% vs. 92.0%, p-value < 0.0001) and 50 + than 15-49 age group (93.7% vs. 91.2%, p-value < 0.0001). The mean rate of reported deaths was higher among men than women (2.37 vs. 1.51 per 1000 persons, p-value < 0.0001) and 50 + than 15-49 age group (2.39 vs. 1.50 per 1000, p-value < 0.0001); the mean rate of reported deaths plus IIT was higher among men (30.1 in men vs. 26.0 in women per 1000, p-value < 0.0001) and higher among 15-49 than 50 + age group (34.7 vs. 22.6 per 1000, p-value < 0.0001).
conclusionsThe mean rate of reported deaths was higher among men in most models despite adjusting for VLS. Further exploration into differences in care-seeking behaviors; coverage of screening, prophylaxis, and/or treatment of opportunistic infections; and more extensive testing options for men to include CD4 is recommended.
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