HIV incidence, viremia, and the national response in Eswatini: Two sequential population-based surveys.
HIV incidence, viremia, and the national response in Eswatini: Two sequential population-based surveys.
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DOI：
10.1371/journal.pone.0260892
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Justman J
中科院分区：
文献类型：
--
作者：
Nkambule R;Philip NM;Reid G;Mnisi Z;Nuwagaba-Biribonwoha H;Ao TT;Ginindza C;Duong YT;Patel H;Saito S;Solmo C;Brown K;Moore CS;Voetsch AC;Bicego G;Bock N;Mhlanga F;Dlamini T;Mabuza K;Zwane A;Sahabo R;Dobbs T;Parekh BS;El-Sadr W;Ryan C;Justman J
With the highest HIV incidence and prevalence globally, the government of Eswatini started a substantial scale-up of HIV treatment and prevention services in 2011. Two sequential large population-based surveys were conducted before and after service expansion to assess the impact of the national response. Cross-sectional, household-based, nationally representative samples of adults, ages 18 to 49 years, were sampled in 2011 and 2016. We measured HIV prevalence, incidence (recent infection based on limiting antigen ≤1.5 optical density units and HIV RNA ≥1000 copies/mL), viral load suppression (HIV RNA <1000 copies/mL among all seropositive adults) and unsuppressed viremia (HIV RNA ≥1000 copies/mL among all, regardless of HIV status) and assessed for temporal changes by conducting a trend analysis of the log ratio of proportions, using a Z statistic distribution. HIV prevalence remained stable from 2011 to 2016 [32% versus 30%, p = 0.10]. HIV incidence significantly declined 48% [2.48% versus 1.30%, p = 0.01]. Incidence remained higher among women than men [2011: 3.16% versus 1.83%; 2016: 1.76% versus 0.86%], with a smaller but significant relative reduction among women [44%; p = 0.04] than men [53%; p = 0.09]. The proportion of seropositive adults with viral load suppression significantly increased from 35% to 71% [p < .001]. The proportion of the total adult population with unsuppressed viremia decreased from 21% to 9% [p < .001]. National HIV incidence in Eswatini decreased by nearly half and viral load suppression doubled over a five-year period. Unsuppressed viremia in the total population decreased 58%. These population-based findings demonstrate the national impact of expanded HIV services in a hyperendemic country.
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影响因子：
168.9
作者：
Montaner, Julio S. G.;Lima, Viviane D.;Barrios, Rolando;Yip, Benita;Wood, Evan;Kerr, Thomas;Shannon, Kate;Harrigan, P. Richard;Hogg, Robert S.;Daly, Patricia;Kendall, Peny
通讯作者：
Kendall, Peny
影响因子：
158.5
作者：
Danel, Christine;Moh, Raoul;Anglaret, Xavier
通讯作者：
Anglaret, Xavier
DOI：
10.1056/nejmoa1702150
发表时间：
2017-11-30
期刊：
The New England journal of medicine
影响因子：
--
作者：
Grabowski MK;Serwadda DM;Gray RH;Nakigozi G;Kigozi G;Kagaayi J;Ssekubugu R;Nalugoda F;Lessler J;Lutalo T;Galiwango RM;Makumbi F;Kong X;Kabatesi D;Alamo ST;Wiersma S;Sewankambo NK;Tobian AAR;Laeyendecker O;Quinn TC;Reynolds SJ;Wawer MJ;Chang LW;Rakai Health Sciences Program
通讯作者：
Rakai Health Sciences Program
影响因子：
120.7
作者：
Kong, Xiangrong;Kigozi, Godfrey;Gray, Ronald H.
通讯作者：
Gray, Ronald H.
DOI：
10.1016/s2352-3018(16)30190-4
发表时间：
2017-02
期刊：
The lancet. HIV
影响因子：
--
作者：
Justman J;Reed JB;Bicego G;Donnell D;Li K;Bock N;Koler A;Philip NM;Mlambo CK;Parekh BS;Duong YT;Ellenberger DL;El-Sadr WM;Nkambule R
通讯作者：
Nkambule R