1 / 17

Pro Vice-Chancellor (Research), University of KwaZulu-Natal

Overview of the HIV epidemic in sub-Saharan Africa. XVIIIth International AIDS Conference, Vienna, 19 July 2010. Salim S. Abdool Karim. Pro Vice-Chancellor (Research), University of KwaZulu-Natal Director: CAPRISA - Centre for the AIDS Programme of Research in SA

rose-cherry
Download Presentation

Pro Vice-Chancellor (Research), University of KwaZulu-Natal

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Overview of the HIV epidemic in sub-Saharan Africa XVIIIth International AIDS Conference, Vienna, 19 July 2010 Salim S. Abdool Karim Pro Vice-Chancellor (Research), University of KwaZulu-Natal Director: CAPRISA - Centre for the AIDS Programme of Research in SA Professor in Clinical Epidemiology, Columbia University Adjunct Professor in Medicine, Cornell University

  2. Overview • Africa in the context of the global HIV epidemic • The evolving epidemic in Africa • Underlying drivers of HIV spread • Conclusion

  3. Global HIV epidemic, 2009 33.4 million living with HIV, 2.7 million new infections, 2 million deaths • Sub-Saharan Africa: • 67% of global burden of HIV (22.4m) • 70% of new HIV infections (1.9m) • 70% of global deaths (1.4m) • ~14m children have lost one or • both parents to HIV/AIDS • 1.8 m children living with HIV Source: UNAIDS 2009

  4. The growing HIV epidemic in Africa Source: UNAIDS. 2006 Report on the global AIDS epidemic. UNAIDS, Geneva

  5. HIV subtype distribution in Africa Source: Los Alamos sequence database Provided by: Carolyn Williamson

  6. Declining epidemics e.g. Uganda HIV prevalence rates in pregnant women in Uganda from 1985 to 2001 Source: Stoneburner RL, Low-Beer D. Population –level HIV declines and behaviour risk avoidance in Uganda. Science 2004; 304: 714-718

  7. Rising epidemics eg. South Africa Initiation of the generalised epidemic Rapid spread of HIV AIDS mortality phase Source: Data from South African Department of Health Antenatal Surveys. www.doh.gov.za/

  8. HIV prevalence among MSM in Africa HIV prevalence in MSM: Range: 6.2% in Egypt to 30.9% in Cape Town Source: Griensven et al. Current Opinion in HIV and AIDS 2009, 4:300–307

  9. Impact of HIV/AIDS on mortality in South Africa in the year 2000 39.0 HIV/AIDS 7.5 Homicide/violence 4.3 Tuberculosis 4.2 Diarrhoeal disease (% years of life lost) 4.1 Road traffic accidents 3.9 Lower respiratory infections 2.7 Stroke 2.5 Ischaemic heart disease 1.7 Low birth weight 1.5 Protein-energy malnutrition Source: Bradshaw et al. South African Medical Journal 2005; 95: 496-503

  10. ART coverage in sub-Saharan Africa in 2008 Source: WHO. Towards Universal Access Scaling up priority HIV/AIDS interventions in the health sector 2009.

  11. Key drivers of the HIV epidemic in sub-Saharan Africa • Gender and HIV • Mobile populations and migrant labour • Sexual networking patterns • Scale-up of proven prevention strategies

  12. 1. Gender and HIV:High HIV incidence in young women 10 Male Female 8 6 Prevalence (%) 4 2 0 <9 10-14 15-19 20-24 25-29 30-39 40-49 >49 Source: Abdool Karim Q, Abdool Karim SS, Singh B, Short R, Ngxongo S. AIDS 1992; 6: 1535-9

  13. High HIV prevalence in young women in Africa Kenya Malawi Lesotho Cameroon

  14. 2. Mobility and migration as underlying drivers of HIV spread

  15. I N 3 0 1 9 0 4 I N . D 7 4 7 I N . D 7 5 7 Z A . G O M N . D 1 0 2 4 I N . D 1 0 4 4 M W 9 6 5 Z A . D L U Z A . R B 1 2 I N . 3 0 1 9 9 9 Z A M 1 8 Z A . D U 3 6 8 9 6 Z A 6 0 2 B W 1 7 A 0 9 Z A . D U 2 8 1 9 6 Z A 6 0 4 Z A . B o o y D Z A . D U 1 7 9 Z A . D U 1 2 3 S A - C O N B _ F R . H X 2 B R Z A . D U 2 0 4 B _ U S . W E A U 1 6 0 Z A . G G 4 Z A . D U 1 5 1 M W 9 5 9 . 1 8 D _ Z R . E L I Z A . D U 4 2 2 D _ Z R . N D K Z A . D U 1 7 2 Z A . N O F H _ C F . 9 0 C R 0 5 6 E T H 2 2 2 0 B W 1 6 B 0 1 H _ B E . V I 9 9 7 Z A . D U 1 5 6 A _ U G . 9 2 U G 0 3 7 Z A . D U 4 6 7 A _ K E . Q 2 3 1 7 Z A . R B 2 B Z A . G G 6 9 2 B R 0 2 5 Z A . G G 3 G _ S E 6 1 6 5 G _ F I . H H 9 7 9 3 - 1 1 B W 1 2 1 0 B W 0 4 0 2 J _ S E 9 1 7 3 2 B W 0 5 0 4 Z A . G G 1 0 Z A . R B 2 2 Z A . D U 1 1 5 9 0 2 Z A 5 1 4 F _ B R . 9 3 B R 0 2 0 J _ S E 9 2 8 0 9 B W 1 1 0 4 Z A . D U 2 5 8 B W 0 1 B 3 F _ B R . B Z 1 6 3 Z A . R B 2 7 3. Sexual networking patterns in southern Africa I N . U I N D 5 B W 1 5 B O 3 Phylogenetic tree analysis S o u t h A f r i c a Z A . G G 5 I n d i a Z A . R B 1 4 I N . U I N D 4 I N . U I N D 6 I N . U I N D 3 Z A . R B 1 8 I N . D 7 6 6 M a l a w i Z A . D U 1 7 4 I N . D 8 0 8 I N . D 7 4 4 M W . S H 7 5 0 I N . 2 1 0 6 8 Z a m b i a I N . 1 1 2 4 6 Z A . R B 1 5 I N . U I N D 7 Z A . R B 1 3 B o t s w a n a Z A . R B 2 1 M W 9 6 0 . 3 9 2 Z A 5 1 7 I N . U I N D 2 I N . U I N 8 I N . D 7 6 0 I N . D 7 4 4 I N . U I N D 1 Z A M 2 0 I 9 6 Z A 3 4 7 Z A . D U 4 5 7 Source: Williamson C, Morris L, Maughan MF, Piug L-H, Dryga SA, Thomas R, Reap EA, Cilliers T, Van Harmelen J, Pascual A, Ramjee G, Frelinger J, Johnston R, Abdool Karim SS, Swanstrom R. AIDS Res Hum Retroviruses 2003; 19: 133-144.

  16. 0.2% Adults with access to HIV testing 4% Harm reduction got injection drug users 8% Prevention of mother-to-child transmission 11% Behaviour change programs for men who have sex with men 16% Behaviour change programs for commercial sex workers 21% Condom access 0 20 40 60 80 100 4. Need to scale-up proven prevention strategies Global Access to existing HIV prevention methods, 2003 Source: UNAIDS et al, 2004

  17. Conclusion • Africa has 10% of world’s population but 67% of the global burden of HIV • Mobility, migrant labour and gender disparity contribute to the spread of HIV in this region • Proven prevention needs further scale-up in sub-Saharan Africa • HIV incidence is highest in young women • New prevention tools that women can use and control are urgently needed

More Related