HIV in Africa: Challenges and directions for the next decade

Bruce L. Gilliam, Devang Patel, Rohit Talwani, Zelalem Temesgen

Research output: Contribution to journalReview article

6 Scopus citations

Abstract

Africa carries a disproportionate burden of the global HIV endemic, accounting for two thirds of the global 33.3 million people living with HIV. While tremendous advances have been made in addressing the HIV epidemic in Africa, considerable challenges remain. Testing for HIV increased by 86% from 2007 to 2009 but more than 75% of people 15-49 years remain unaware of their HIV status. CD4 count at diagnosis tends to be low and linkage to care and treatment is suboptimal. The scale-up of antiretroviral therapy is ongoing but is hampered by the lack of diagnostic capability to monitor response to therapy and a substantial healthcare workforce shortage. Prevention strategies such as male circumcision, pre-exposure prophylaxis, and antiretroviral therapy for prevention have generated great excitement but cost and healthcare infrastructure deficiencies may limit their widespread applicability. Operational research to validate and inform treatment decisions, health care policies, and prevention strategies is sorely needed.

Original languageEnglish (US)
Pages (from-to)91-101
Number of pages11
JournalCurrent Infectious Disease Reports
Volume14
Issue number1
DOIs
StatePublished - Feb 1 2012

Keywords

  • Adherence
  • Africa
  • Antiretroviral treatment
  • Cryptococcus
  • Early diagnosis
  • Efficacy
  • HIV
  • Male circumcision
  • Microbicides
  • Monitoring
  • Nurse-managed vs. doctor-managed care
  • Operational research
  • Preexposure prophylaxis
  • Residency
  • Resistance
  • Resource-limited setting
  • Scaling-up
  • Task-shifting
  • Therapeutic sequencing
  • Treatment failure
  • Tuberculosis
  • Vaccine
  • Viral load
  • When to start treatment
  • Work force

ASJC Scopus subject areas

  • Infectious Diseases

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