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This study delves into the impact of HIV/AIDS epidemic in Africa, reflecting global statistics and geographic disparities. It emphasizes the role of Demographic Surveillance System (DSS) sites in monitoring and evaluating antiretroviral therapy (ART) roll-out programs across various African regions to assess the effects on individuals, families, populations, and health systems. The study aims to uncover insights on ART uptake, survival rates, quality of life, household economics, and societal stigmas related to HIV/AIDS.
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HIV and AIDS Epidemic: Potential Contribution from DSS sites Nyovani Madise, PhD Centre for Global Health, Population, Poverty & Policy
What Do We Already Know? • 39 million infected with virus • 4 million new infections per year • Globally, HIV infections are unevenly spread- 29 million of those infected living in Africa
Geography of HIV and AIDS Prevalence in adults, 2005
HIV epidemic in sub-Saharan Africa, 1985‒2005* Number of people living with HIV (millions) % HIV prevalence, adult (15‒49) 30 15.0 12.5 25 20 10.0 7.5 15 5.0 10 2.5 5 0 0.0 1985 1990 1995 2000 2005 * Number of people living with HIV % HIV prevalence, adult (15-49) This bar indicates the range around the estimate 2.2 Source: UNAIDS 2006 Report on Global AIDS Epidemic
South Africa in 2020 Without AIDS: Population by age and sex, South Africa, 2020 (under “no AIDS” scenario) Source: United Nations, World Population Prospects: The 2004 Revision, CD-ROM Edition, Extended Dataset (2005).
South Africa in 2020 With AIDS (Medium AIDS Scenario) Source: United Nations, World Population Prospects: The 2004 Revision, CD-ROM Edition, Extended Dataset (2005).
National Wealth & HIV Prevalence Botswana South Africa 3000 $ Namibia 2000 $ Swaziland 1000 $ Cote d’Ivoire Zimbabwe Uganda Zambia Per capita 1999 10 10 20 30 Adult HIV prevalence end 1999
HIV Prevalence by Age at First Sexual intercourse Women Sources: DHS surveys
A Population-based Longitudinal Assessment of ART Rollout:Effects on Individuals, Populations, and, Health SystemsProposal byINDEPTH Network
5-year evaluation of the antiretroviral therapy (ART) roll-out programmes at INDEPTH sites in West, East and Southern Africa
Collaborating Sites • Agincourt (South Africa) • Nairobi (Kenya) • Bandim (Guinea Bissau) • Ifakara (Tanzania) • Kisumu (Kenya)
Overall Objectives Effect of ART roll-out on • Individuals under treatment & families • The population • Health systems
Effect on Individuals and Their Families • Survival after starting ART • Quality-of-life on ART • Sexual behaviour of individuals taking ART • Economic impact on households with member taking ART
Effect of ART on the Population • Trends in mortality, morbidity, and survival in DSS communities • Household structure and childcare • Sexual behaviour in the population • Stigma at population level • Access to ART- what % of those who need it are receiving it?
Effect of ART and the Health System • Understanding ART roll-out national policies, how they are developed/revised • Interpretation and application of policies at district level • Equity in provision of ART • ART impacts on other health services • Improving effectiveness of ART roll-out programmes
Proposed Activities Existing DSS activities • Verbal autopsies on cause of death • Population and household structure • Socio-economic status Additional activities • Population-based HIV testing • Morbidity, sexual behaviour studies • Closer linkage with health service provider