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Declines in HIV incidence among men and women in a South African population-based cohort

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  • Alain Vandormael

    (Africa Health Research Institute (AHRI)
    University of KwaZulu-Natal (UKZN)
    University of Heidelberg
    KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, UKZN)

  • Adam Akullian

    (Institute for Disease Modeling
    Department of Global Health, University of Washington)

  • Mark Siedner

    (Africa Health Research Institute (AHRI)
    Massachusetts General Hospital
    Harvard Medical School)

  • Tulio Oliveira

    (KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, UKZN
    Department of Global Health, University of Washington
    Centre for the AIDS Programme of Research in South Africa (CAPRISA))

  • Till Bärnighausen

    (Africa Health Research Institute (AHRI)
    University of Heidelberg
    Harvard T.H. Chan School of Public Health)

  • Frank Tanser

    (Africa Health Research Institute (AHRI)
    University of KwaZulu-Natal (UKZN)
    Centre for the AIDS Programme of Research in South Africa (CAPRISA)
    University of Lincoln)

Abstract

Over the past decade, there has been a massive scale-up of primary and secondary prevention services to reduce the population-wide incidence of HIV. However, the impact of these services on HIV incidence has not been demonstrated using a prospectively followed, population-based cohort from South Africa—the country with the world’s highest rate of new infections. To quantify HIV incidence trends in a hyperendemic population, we tested a cohort of 22,239 uninfected participants over 92,877 person-years of observation. We report a 43% decline in the overall incidence rate between 2012 and 2017, from 4.0 to 2.3 seroconversion events per 100 person-years. Men experienced an earlier and larger incidence decline than women (59% vs. 37% reduction), which is consistent with male circumcision scale-up and higher levels of female antiretroviral therapy coverage. Additional efforts are needed to get more men onto consistent, suppressive treatment so that new HIV infections can be reduced among women.

Suggested Citation

  • Alain Vandormael & Adam Akullian & Mark Siedner & Tulio Oliveira & Till Bärnighausen & Frank Tanser, 2019. "Declines in HIV incidence among men and women in a South African population-based cohort," Nature Communications, Nature, vol. 10(1), pages 1-10, December.
    • Handle: RePEc:nat:natcom:v:10:y:2019:i:1:d:10.1038_s41467-019-13473-y
    DOI: 10.1038/s41467-019-13473-y
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    Cited by:

    1. Nesamoney, Sophia N. & Mejía-Guevara, Iván & Cislaghi, Beniamino & Weber, Ann M. & Mbizvo, Michael T. & Darmstadt, Gary L., 2022. "Social normative origins of the taboo gap and implications for adolescent risk for HIV infection in Zambia," Social Science & Medicine, Elsevier, vol. 312(C).

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