ArticleBMC public health2025
Behavioral HIV-serosurvey reveals clustering of risk factors likely plays a key role in sustaining HIV epidemic in rural KwaZulu-Natal, South Africa.
Article in BMC public health, 2025. 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 1 paper.
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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.
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1 citing paper in PubMed.
Corrections and comments
- Erratum issued
Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
New Human immunodeficiency virus (HIV) infections among adults have decreased in the last ten years in high HIV prevalent countries. However, unsuppressed individuals with high-risk sexual practices can play a key role in transmitting HIV and maintaining the HIV epidemic. We assessed the association between sexual behavior, HIV awareness, antiretroviral therapy (ART) intake and viral suppression, and the age-gender groups most at risk of maintaining HIV transmission in KwaZulu-Natal, South Africa.We conducted a population-based cross-sectional survey including adolescents and adults aged 15 years and above from August to December 2018 in KwaZulu-Natal, South Africa. In this analysis we included only data from HIV-positive participants aged 15-59 years.In total, 862 HIV-positive individuals aged 15-59 years were included, 76.2% (657) were women, and the median age was 36 [IQR 29-46] years, 10.1% (95%CI 8.2-12.3) were unaware of their HIV status, 15.8% (95%CI 13.4-18.2) not on ART, and 16.3% (95%CI 13.9-18.9) virally unsuppressed. Among the 671 participants who had sexual intercourse in the preceding year, 46.9% (315) consistently used condoms. Among those who provided information on the number of sexual partners, 7.5% (64/856) reported more than one. Overall, 10.6% (88/831) (95%CI 8.7-12.9) of HIV-positive participants were either at high or very high risk of sexually transmitting HIV. Of these, 42.0% (37/88) (95%CI 32.1-52.7) were women aged 20-34 years, 39.8% (35/88) (95%CI 30.0-50.4) were men aged 20-59 years, 50.0% (44/88) (95%CI 39.6-60.4) were unaware of their HIV-positive status and 76.1% (67/88) (95%CI 66.0-84.0) were not on ART. Within the 2.3% (95%CI 1.5-3.6) individuals at very high risk of HIV transmission (19 individuals virally unsuppressed with more than one partner and inconsistent condom use), 68.4% (13/19) (95%CI 43.4-85.9) were men aged 20 to 59 years, 52.6% (10/19) (95%CI 29.7-74.5) were unaware of their HIV- positive status, and 78.9% (15/19) (95%CI 53.5-92.4) were untreated.Efforts and age-gender targeted interventions to increase HIV diagnosis and HIV-positivity awareness, detect early ART treatment failure, provide enhanced adherence support and second- or third-line ART, as well as promote behavioral-risk reduction interventions, are needed to reduce the pool of individuals at high-risk of transmitting HIV.
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