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Beyond HIV prevalence: identifying people living with HIV within underserved areas in South Africa

INTRODUCTION: Despite progress towards the Joint United Nations Programme on HIV/AIDS 95-95-95 targets, South Africa is still suffering from one of the largest HIV epidemics globally. In this study, we generated high-resolution HIV prevalence maps and identified people living with HIV (PLHIV) in und...

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Autores principales: Kim, Hana, Tanser, Frank, Tomita, Andrew, Vandormael, Alain, Cuadros, Diego F
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061852/
https://www.ncbi.nlm.nih.gov/pubmed/33883186
http://dx.doi.org/10.1136/bmjgh-2020-004089
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author Kim, Hana
Tanser, Frank
Tomita, Andrew
Vandormael, Alain
Cuadros, Diego F
author_facet Kim, Hana
Tanser, Frank
Tomita, Andrew
Vandormael, Alain
Cuadros, Diego F
author_sort Kim, Hana
collection PubMed
description INTRODUCTION: Despite progress towards the Joint United Nations Programme on HIV/AIDS 95-95-95 targets, South Africa is still suffering from one of the largest HIV epidemics globally. In this study, we generated high-resolution HIV prevalence maps and identified people living with HIV (PLHIV) in underserved areas to provide essential information for the optimal allocation of HIV-related services. METHODS: The data come from the South Africa Demographic and Health Survey conducted in 2016 and spatial variables from other published literature. We produced high-resolution maps of HIV prevalence and underserved areas, defined as a greater than 30 min travel time to the nearest healthcare facility. Using these maps and the population density, we mapped PLHIV and the PLHIV within underserved areas for 30, 60 and 120 min thresholds. RESULTS: There was substantial geographic variation in HIV prevalence, ranging from 1.4% to 24.2%, with a median of 11.5% for men, and from 2.1% to 48.1%, with a median of 20.6% for women. Gauteng province showed the highest density for both HIV prevalence and PLHIV. 80% of all areas in the country were identified as underserved areas (30 min threshold), which contained more than 16% and 20% of the total men and women living with HIV, respectively. KwaZulu-Natal province had the largest number of PLHIV in underserved areas (30 min threshold) and showed less than one healthcare facility per 1000 PLHIV. CONCLUSION: Our study showed extensive spatial variation of HIV prevalence and significant numbers of PLHIV in underserved areas in South Africa. Moreover, we identified locations where HIV-related services need to be intensified to reach the ~1.5 million PLHIV in underserved areas, particularly in KwaZulu-Natal province, with less than one healthcare facility per 1000 PLHIV.
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spelling pubmed-80618522021-05-11 Beyond HIV prevalence: identifying people living with HIV within underserved areas in South Africa Kim, Hana Tanser, Frank Tomita, Andrew Vandormael, Alain Cuadros, Diego F BMJ Glob Health Original Research INTRODUCTION: Despite progress towards the Joint United Nations Programme on HIV/AIDS 95-95-95 targets, South Africa is still suffering from one of the largest HIV epidemics globally. In this study, we generated high-resolution HIV prevalence maps and identified people living with HIV (PLHIV) in underserved areas to provide essential information for the optimal allocation of HIV-related services. METHODS: The data come from the South Africa Demographic and Health Survey conducted in 2016 and spatial variables from other published literature. We produced high-resolution maps of HIV prevalence and underserved areas, defined as a greater than 30 min travel time to the nearest healthcare facility. Using these maps and the population density, we mapped PLHIV and the PLHIV within underserved areas for 30, 60 and 120 min thresholds. RESULTS: There was substantial geographic variation in HIV prevalence, ranging from 1.4% to 24.2%, with a median of 11.5% for men, and from 2.1% to 48.1%, with a median of 20.6% for women. Gauteng province showed the highest density for both HIV prevalence and PLHIV. 80% of all areas in the country were identified as underserved areas (30 min threshold), which contained more than 16% and 20% of the total men and women living with HIV, respectively. KwaZulu-Natal province had the largest number of PLHIV in underserved areas (30 min threshold) and showed less than one healthcare facility per 1000 PLHIV. CONCLUSION: Our study showed extensive spatial variation of HIV prevalence and significant numbers of PLHIV in underserved areas in South Africa. Moreover, we identified locations where HIV-related services need to be intensified to reach the ~1.5 million PLHIV in underserved areas, particularly in KwaZulu-Natal province, with less than one healthcare facility per 1000 PLHIV. BMJ Publishing Group 2021-04-21 /pmc/articles/PMC8061852/ /pubmed/33883186 http://dx.doi.org/10.1136/bmjgh-2020-004089 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Kim, Hana
Tanser, Frank
Tomita, Andrew
Vandormael, Alain
Cuadros, Diego F
Beyond HIV prevalence: identifying people living with HIV within underserved areas in South Africa
title Beyond HIV prevalence: identifying people living with HIV within underserved areas in South Africa
title_full Beyond HIV prevalence: identifying people living with HIV within underserved areas in South Africa
title_fullStr Beyond HIV prevalence: identifying people living with HIV within underserved areas in South Africa
title_full_unstemmed Beyond HIV prevalence: identifying people living with HIV within underserved areas in South Africa
title_short Beyond HIV prevalence: identifying people living with HIV within underserved areas in South Africa
title_sort beyond hiv prevalence: identifying people living with hiv within underserved areas in south africa
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061852/
https://www.ncbi.nlm.nih.gov/pubmed/33883186
http://dx.doi.org/10.1136/bmjgh-2020-004089
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