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

  • The Global Epidemic (S Vermund, Section Editor)
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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.

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Notes

  1. Swaziland, Lesotho, Botswana, South Africa, Zimbabwe, Namibia, Zambia, Mozambique, Angola and Malawi

  2. According to the President’s Emergency Plan for AIDS Relief (PEPFAR), an AIDS-free generation entails that first, no one will be born with the virus; second, that as people get older, they will be at a far lower risk of becoming infected than they are today; and third, that if they do acquire HIV, they will get treatment that keeps them healthy and prevents them from transmitting the virus to others.

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Conflict of Interest

Wim Delva declares that he has no conflict of interest.

Quarraisha Abdool Karim has a patent PCT61/354.050 and PCT 61/357,892 (filed in 2011) for Tenofovir gel against HSV-1 and HSV-2 pending.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. The South African DST/NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), University of Stellenbosch, Stellenbosch, South Africa

    Wim Delva

  2. Center for Statistics, Hasselt University, Diepenbeek, Belgium

    Wim Delva

  3. International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium

    Wim Delva

  4. CAPRISA, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Private Bag 7, Congella, 4013, KwaZulu-Natal, South Africa

    Quarraisha Abdool Karim

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Delva, W., Abdool Karim, Q. The HIV Epidemic in Southern Africa – Is an AIDS-Free Generation Possible?. Curr HIV/AIDS Rep 11, 99–108 (2014). https://doi.org/10.1007/s11904-014-0205-0

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