HIV and TB in Eastern and Southern Africa: Evidence for behaviour change and the impact of ART

TL;DR

This paper reviews HIV and TB data in Eastern and Southern Africa to evaluate the impact of ART and behavior change on reducing infectiousness, informing future epidemic projections and target setting.

Contribution

It provides a comprehensive assessment of current HIV and TB prevalence, ART coverage, and notification rates to support future epidemic modeling and policy planning.

Findings

ART coverage has increased significantly in ESA.

Behavior change has contributed to reduced infectiousness.

Current data supports setting realistic future treatment targets.

Abstract

The United Nations Joint Programme on HIV/AIDS (UNAIDS) has set a target to ensure that 15 million HIV-positive people in the world would be receiving combination anti-retroviral treatment (ART) by 2015. This target is likely to be reached and new targets for 2020 and 2030 are needed. Eastern and Southern Africa (ESA) account for approximately half of all people living with HIV in the world and it will be especially important to set reachable and affordable targets for this region. In order to make future projections of HIV and TB prevalence, incidence and mortality assuming different levels of ART scale-up and coverage, it is first necessary to assess the current state of the epidemic. Here we review national data on the prevalence of HIV, the coverage of ART and the notification rates of TB to provide a firm basis for making future projections. We use the data to assess the extent to which behaviour change and ART have reduced the number of people living with HIV who remain infectious.