The geographic distribution of priority population groups for the elimination of mother-to-child transmission of HIV in South Africa

Show simple item record Moyo, Faith Mazanderani, Ahmad Haeri Kufa, Tendesayi Sherman, Gayle G. 2021-04-16T12:55:34Z 2021-04-16T12:55:34Z 2020-04-08
dc.description S1 Table. HIV prevalence rates by province in South Africa, 2018. en_ZA
dc.description S2 Table. 95% Confidence Intervals by indicator: Thembisa Model. en_ZA
dc.description.abstract BACKGROUND Women of reproductive age living with HIV (WRLHIV), HIV-positive pregnant women, adolescent girls and young women (AGYW) are key populations for eliminating mother-to-child of HIV (eMTCT) in South Africa. We describe the geographical distribution of WRLHIV, their pregnant counterparts and AGYW for risk-adjusted allocation of eMTCT interventions. METHODS For the year 2018, we triangulated data from the Thembisa Model with five routine HIVrelated and demographic data sources to determine the distribution of WRLHIV (15–49 years) and AGYW (15–24 years) nationally and by province. Data analysed included total population estimates, number of live-births, live-births to HIV-positive women, age-specific HIV prevalence rates, intrauterine (IU)-transmission rates and IU-case rates/100 000 livebirths. IU-transmission rates and IU-case rates were calculated from de-duplicated routine HIV test-data for neonates (aged <7days). Data de-duplication was achieved by a patientlinking algorithm that uses probabilistic matching of demographics (name, surname, date of birth), supplemented by manual matching to account for spelling errors. RESULTS There were 58 million people in South Africa in 2018. Females (all ages) constituted 51% of the population. Women of reproductive age constituted 27% and AGYW constituted 8% of the total population. WRLHIV, AGYW living with HIV and HIV-positive pregnant women accounted for 7%, 0.8% and 0.4% of the total population respectively. Gauteng was the most populous province followed by KwaZulu-Natal, with Western Cape and Eastern Cape in third and fourth positions. The distribution of WRLHIV and AGYW followed a similar trend. However, Mpumalanga and Limpopo provinces had higher proportions of WRLHIV and AGYW living with HIV ahead of Western Cape. KwaZulu-Natal had the highest number of live-births to HIV-positive women. The national IU-transmission rate of <1% translated into 241 cases/100 000. While provincial IU-case rates were fairly similar at 179–325, districts IU-case rates varied, ranging from 87–415 cases/100 000 live-births. CONCLUSION Findings suggest that the need for eMTCT interventions is greatest in Gauteng, KwaZulu- Natal, Western Cape and Eastern Cape. Limpopo and Mpumalanga provinces may require more HIV prevention and family planning services because of high fertility rates, high number of WRLHIV and AGYW living with HIV. eMTCT will require robust viral load monitoring among WRLHIV, pregnant and breastfeeding women. The national laboratory database can provide this service near-real time. en_ZA
dc.description.department Medical Virology en_ZA
dc.description.librarian am2021 en_ZA
dc.description.sponsorship The ELMA Foundation en_ZA
dc.description.uri en_ZA
dc.identifier.citation Moyo F, Haeri Mazanderani A, Kufa T, Sherman GG (2020) The geographic distribution of priority population groups for the elimination of mother-to-child transmission of HIV in South Africa. PLoS ONE 15(4): e0231228. en_ZA
dc.identifier.issn 1932-6203 (online)
dc.identifier.other 10.1371/journal.pone.0231228
dc.language.iso en en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights © 2020 Moyo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License. en_ZA
dc.subject Women en_ZA
dc.subject Pregnant en_ZA
dc.subject Reproductive age en_ZA
dc.subject Human immunodeficiency virus (HIV) en_ZA
dc.subject Mother-to-child transmission (MTCT) en_ZA
dc.subject South Africa (SA) en_ZA
dc.subject Women of reproductive age living with HIV (WRLHIV) en_ZA
dc.subject Adolescent girls and young women (AGYW) en_ZA
dc.title The geographic distribution of priority population groups for the elimination of mother-to-child transmission of HIV in South Africa en_ZA
dc.type Article en_ZA

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