scholarly journals Population-level effect of potential HSV2 prophylactic vaccines on HIV incidence in sub-Saharan Africa

Vaccine ◽  
2009 ◽  
Vol 27 (6) ◽  
pp. 940-946 ◽  
Author(s):  
Esther E. Freeman ◽  
Richard G. White ◽  
Roel Bakker ◽  
Kate K. Orroth ◽  
Helen A. Weiss ◽  
...  
Keyword(s):  
Population Level ◽  
Sub Saharan Africa ◽  
Hiv Incidence ◽  
Prophylactic Vaccines ◽  
Sub Saharan ◽  
Level Effect

scholarly journals Population-level effect of HSV-2 therapy on the incidence of HIV in sub-Saharan Africa

2008 ◽  
Vol 84 (Suppl 2) ◽  
pp. ii12-ii18 ◽  
Author(s):  
R G White ◽  
E E Freeman ◽  
K K Orroth ◽  
R Bakker ◽  
H A Weiss ◽  
...  
Keyword(s):  
Population Level ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
Level Effect

scholarly journals Incidence of HIV in Sub-Saharan Africa, 2000–2015: The Interplay Between Social Determinants and Behavioral Risk Factors

2021 ◽  
Author(s):  
Deepa Jahagirdar ◽  
Magdalene Walters ◽  
Avina Vongpradith ◽  
Xiaochen Dai ◽  
Amanda Novotney ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Incidence Rates ◽  
Sub Saharan Africa ◽  
Behavioral Risk ◽  
Hiv Incidence ◽  
Hiv Knowledge ◽  
African Countries ◽  
Final Model ◽  
Sub Saharan ◽  
Disease Study

AbstractHIV incidence in sub-Saharan Africa declined substantially between 2000 and 2015. In this analysis, we consider the relative associations of nine structural and individual determinants with this decline. A linear mixed effects model of logged HIV incidence rates versus determinants was used. The data were from mathematical modelling as part of the 2019 Global Burden of Disease Study in 43 sub-Saharan African countries. We used forwards selection to determine a single final model of HIV incidence rate. The association of economic variables and HIV knowledge with incidence was found to be driven by education, while ART coverage had the largest impact on other determinants’ coefficients. In the final model, education years per capita contributed the most to explaining variation in HIV incidence rates; a 1-year increase in mean education years was associated with a 0.39 (− 0.56; − 0.2, t = − 4.48 p < 0.01) % decline in incidence rate while a unit increase in ART coverage was associated with a 0.81 (− 1.34; − 0.28, t = − 3.01, p < 0.01) % decline in incidence rate.

scholarly journals Risk heterogeneity in compartmental HIV transmission models of ART as prevention in Sub-Saharan Africa: A scoping review

2021 ◽  
Author(s):  
Jesse Knight ◽  
Rupert Kaul ◽  
Sharmistha Mishra
Keyword(s):  
Scoping Review ◽  
Hiv Transmission ◽  
Population Level ◽  
Sub Saharan Africa ◽  
Key Populations ◽  
Hiv Diagnosis ◽  
Cascade Transitions ◽  
Sub Saharan ◽  
Modelling Assumptions ◽  
Transmission Models

AbstractObjectiveTransmission models provide complementary evidence to clinical trials about the potential population-level incidence reduction attributable to ART (ART prevention impact). Different modelling assumptions about risk heterogeneity may influence projected ART prevention impacts. We sought to review representations of risk heterogeneity in compartmental HIV transmission models applied to project ART prevention impacts in Sub-Saharan Africa.DesignScoping review to identify common modelling assumptions and applications.MethodsWe systematically reviewed studies published before January 2020 that used non-linear compartmental models of sexual HIV transmission to simulate ART prevention impacts in Sub-Saharan Africa. We summarized data on model structure/assumptions (factors) related to risk and intervention heterogeneity, and explored crude associations of ART prevention impact with modelled factors.ResultsOf 1384 search hits, 94 studies were included, which primarily modelled medium/high prevalence epidemics in East/Southern Africa. 64 studies considered sexual activity stratification and 39 modelled at least one key population. 21 studies modelled faster/slower ART cascade transitions (HIV diagnosis, ART initiation, or cessation) by risk group, including 8 with faster and 4 with slower cascade transitions among key populations versus the wider population. Models without activity stratification predicted the largest ART prevention impacts, followed by models with key populations that had faster cascade transitions versus the wider population.ConclusionsAmong compartmental transmission models applied to project ART prevention impacts, representations of risk heterogeneity and projected impacts varied considerably, where models with less heterogeneity tended to predict larger impacts. The potential influence of modelling assumptions about risk and intervention heterogeneity should be further explored.

scholarly journals How education mitigates the realisation of fertility intentions: Is sub-Saharan Africa different?

2018 ◽  
Author(s):  
Melanie Channon ◽  
SARAH HARPER
Keyword(s):  
Educational Achievement ◽  
Fertility Transition ◽  
Population Level ◽  
Fertility Intentions ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Individual Level ◽  
Highly Educated ◽  
Sub Saharan ◽  
The Individual

The gap between achieved fertility and fertility ideals is notably higher in sub-Saharan Africa (SSA) than elsewhere, relating to both under- and overachievement of fertility ideals. We consider the extent to which the relationship between fertility ideals and achieved fertility is mitigated by educational achievement. Further, we consider if the effect of education acts differently in SSA, and thereby hypothesise how increasing levels of education in SSA may decrease fertility.We use 227 Demographic and Health Surveys from 57 countries worldwide to look at population- and individual-level measures of achieving fertility ideals. Population level measures are used to assess whether the correspondence between fertility intentions and achievements differ by level of education. We then look at the individual-level determinants of both under- and overachieving fertility intentions. An average of 40% of women in SSA underachieve their stated fertility intentions compared to 26% in non-SSA countries. Furthermore, the educational gradient of underachievement is different in SSA where higher levels of education are not related to better correspondence between fertility intentions and achievements. We argue that the phenomenon of underachieving fertility ideals (or unrealized fertility) may be of particular importance for the ongoing fertility transition throughout SSA, especially for highly educated groups.

scholarly journals Clusters of sub-Saharan African countries based on sociobehavioural characteristics and associated HIV incidence

2019 ◽  
Author(s):  
Aziza Merzouki ◽  
Janne Estill ◽  
Erol Orel ◽  
Kali Tal ◽  
Olivia Keiser
Keyword(s):  
National Level ◽  
Principal Component ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
People Living With Hiv ◽  
Hiv Incidence ◽  
African Countries ◽  
Aggregated Data ◽  
Sub Saharan ◽  
Ssa Countries

AbstractIntroductionHIV incidence varies widely between sub-Saharan African (SSA) countries. This variation coincides with a substantial sociobehavioural heterogeneity, which complicates the design of effective interventions. In this study, we investigated how sociobehavioural heterogeneity in sub-Saharan Africa could account for the variance of HIV incidence between countries.MethodsWe analysed aggregated data, at the national-level, from the most recent Demographic and Health Surveys of 29 SSA countries [2010-2017], which included 594’644 persons (183’310 men and 411’334 women). We preselected 48 demographic, socio-economic, behavioural and HIV-related attributes to describe each country. We used Principal Component Analysis to visualize sociobehavioural similarity between countries, and to identify the variables that accounted for most sociobehavioural variance in SSA. We used hierarchical clustering to identify groups of countries with similar sociobehavioural profiles, and we compared the distribution of HIV incidence (estimates from UNAIDS) and sociobehavioural variables within each cluster.ResultsThe most important characteristics, which explained 69% of sociobehavioural variance across SSA among the variables we assessed were: religion; male circumcision; number of sexual partners; literacy; uptake of HIV testing; women’s empowerment; accepting attitude toward people living with HIV/AIDS; rurality; ART coverage; and, knowledge about AIDS. Our model revealed three groups of countries, each with characteristic sociobehavioural profiles. HIV incidence was mostly similar within each cluster and different between clusters (median(IQR); 0.5/1000(0.6/1000), 1.8/1000(1.3/1000) and 5.0/1000(4.2/1000)).

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