Drastic drop in new HIV infections

A NOTABLE decrease in HIV infections in northern KZN has been largely attributed to male medical circumcision and higher uptakes of antiretroviral therapy among women.

This is according to the Africa Health Research Institute (AHRI) whose research showed a 43% drop in new HIV infections in the Hlabisa area between 2012 and 2017.

These findings were consistent with studies undertaken in Uganda, western Kenya and eSwatini (Swaziland) at about the same time, which revealed a 42% drop in the Rakai region of Uganda and a 50% drop in new infections in western Kenya.

For the AHRI study, scientists followed a cohort of 22 239 HIV-uninfected men and women in AHRI’s health and demographic surveillance and intervention area in Hlabisa, to identify new HIV infections.

This, the centre said, is the gold-standard approach to estimate infection rates.

The research was recently published in the journal Nature Communications and reveals unequal declines in the rates of new HIV infections among men and women.

Male incidence declined by 59% while female incidence dropped by 37%.

‘HIV-uninfected men likely benefitted from the scale-up of voluntary medical male circumcision (VMMC) and higher rates of antiretroviral therapy uptake among women,’ said the paper’s lead author, Dr Alain Vandormael.

‘At least partly due to pregnancy-related HIV screening and treatment programmes, women are more likely than men to test for HIV, start ART early and achieve long-term viral suppression – which reduces the risk of transmitting the virus.

‘Given the heterosexual nature of the HIV epidemic in the AHRI study area, this in turn means that men had a comparatively lower risk of getting HIV from their female sexual partners.’

Research suggested that greater effort is required to get more men onto consistent, supressive treatment so new HIV infections can be reduced in women.

‘We have seen 20 years of increasing or, at best, plateauing HIV incidence in this region of KZN,’ said co-author and AHRI Faculty Member Dr Mark Siedner.

‘So, it is a much-needed glimpse of light in the tunnel to finally see evidence that widespread access to HIV treatment, male medical circumcision and promotion of safer sexual practices can start to bend that curve.

‘It’s early yet and there is so much more work to be done to get HIV prevention tools in the hands of those who need them in KZN – and get these rates down to zero – which is of course, our ultimate goal.

‘But it is very reassuring to know that these positive signs of change have begun.’

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