Current HIV/AIDS Reports

, Volume 11, Issue 2, pp 99–108

The HIV Epidemic in Southern Africa – Is an AIDS-Free Generation Possible?

Authors

  • Wim Delva
    • The South African DST/NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA)University of Stellenbosch
    • Center for StatisticsHasselt University
    • International Centre for Reproductive Health (ICRH)Ghent University
    • CAPRISA, Nelson R Mandela School of MedicineUniversity of KwaZulu-Natal
The Global Epidemic (S Vermund, Section Editor)

DOI: 10.1007/s11904-014-0205-0

Cite this article as:
Delva, W. & Abdool Karim, Q. Curr HIV/AIDS Rep (2014) 11: 99. doi:10.1007/s11904-014-0205-0

Abstract

Southern Africa, home to about 20 % of the global burden of infection continues to experience high rates of new HIV infection despite substantial programmatic scale-up of treatment and prevention interventions. While several countries in the region have had substantial reductions in HIV infection, almost half a million new infections occurred in this region in 2012. Sexual transmission remains the dominant mode of transmission. A recent national household survey in Swaziland revealed an HIV prevalence of 14.3 % among 18–19 year old girls, compared to 0.8 % among their male peers. Expanded ART programmes in Southern Africa have resulted in dramatically decreased HIV incidence and HIV mortality rates. In South Africa alone, it is estimated that more than 2.1 million of the 6.1 million HIV-positive people were receiving ART by the end of 2012, and that this resulted in more than 2.7 million life-years saved, and hundreds of thousands of HIV infections averted. Biological, behavioural and structural factors all contribute to the ongoing high rates of new HIV infection; however, as the epidemic matures and mortality is reduced from increased ART coverage, epidemiological trends become hard to quantify. What is clear is that a key driver of the Southern African epidemic is the high incidence rate of infection in young women, a vulnerable population with limited prevention options. Moreover, whilst ongoing trials of combination prevention, microbicides and behavioural economics hold promise for further epidemic control, an AIDS-free generation will not be realised unless incident infections in key populations are reduced.

Keywords

South Africa AIDS Global epidemic Southern Africa AIDS-free generation Infection Microbicides Combination prevention HIV-positive ART Review

Copyright information

© Springer Science+Business Media New York 2014