Longitudinal Trends in the Prevalence of Detectable HIV Viremia: Population-Based Evidence from Rural KwaZulu-Natal, South Africa

Vandormael, A., Bärnighausen, T., Herbeck, J. , Tomita, A., Phillips, A., Pillay, D., De Oliveira, T. and Tanser, F. (2018) Longitudinal Trends in the Prevalence of Detectable HIV Viremia: Population-Based Evidence from Rural KwaZulu-Natal, South Africa. Clinical Infectious Diseases, 66 (8). pp. 1254-1260. ISSN 1058-4838

Full content URL: https://doi.org/10.1093/cid/cix976

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Item Type:Article
Item Status:Live Archive

Abstract

Background
The prevalence of detectable viremia has previously been used to infer the potential for ongoing human immunodeficiency virus (HIV) transmission. To date, no study has evaluated the longitudinal change in the prevalence of detectable viremia within the HIV-positive community (PDV+) and the entire population (PDVP) using data from a sub-Saharan African setting.

Methods
In 2011, 2013, and 2014, we obtained 6752 HIV-positive and 15415 HIV-negative test results from a population-based surveillance system in the KwaZulu-Natal province of South Africa. We quantified the PDV+ as the proportion of the 6752 HIV-positive results with a viral load >1550 copies/mL and the PDVP as the proportion of the 6752 HIV-positive and 15415 HIV-negative results with a viral load >1550 copies/mL.

Results
Between 2011 and 2014, the PDV+ decreased by 16.5 percentage points (pp) for women (from 71.8% to 55.3%) and 10.6 pp for men (from 77.8% to 67.2%). However, a steady rise in the overall HIV prevalence, from 26.7% to 32.4%, offset the declines in the PDV+ for both sexes. For women, the PDVP decreased by only 2.1 pp, from 21.3% to 19.2%, but for men, the PDVP actually increased by 1.6 pp, from 14.6% to 16.2%, over the survey period.

Conclusions
The PDV+, which is currently being tracked under the UNAIDS 90-90-90 targets, may not be an accurate indicator of the potential for ongoing HIV transmission. There is a critical need for countries to monitor and report the prevalence of detectable viremia among all adults, irrespective of HIV status.

Additional Information:cited By 4
Divisions:College of Social Science > Lincoln Institute of Health
ID Code:37546
Deposited On:09 Oct 2019 15:09

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