HIV in Africa: Challenges and directions for the next decade

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

Research output: Contribution to journalArticle

6 Citations (Scopus)

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 2012

Fingerprint

HIV
Delivery of Health Care
Therapeutics
Male Circumcision
CD4 Lymphocyte Count
Health Policy
Health Care Costs
Direction compound
Research

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

Cite this

HIV in Africa : Challenges and directions for the next decade. / Gilliam, Bruce L.; Patel, Devang; Talwani, Rohit; Temesgen, Zelalem.

In: Current Infectious Disease Reports, Vol. 14, No. 1, 02.2012, p. 91-101.

Research output: Contribution to journalArticle

Gilliam, Bruce L. ; Patel, Devang ; Talwani, Rohit ; Temesgen, Zelalem. / HIV in Africa : Challenges and directions for the next decade. In: Current Infectious Disease Reports. 2012 ; Vol. 14, No. 1. pp. 91-101.
@article{7d2de2d96d934dc0aaa9f644bce8f794,
title = "HIV in Africa: Challenges and directions for the next decade",
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.",
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",
author = "Gilliam, {Bruce L.} and Devang Patel and Rohit Talwani and Zelalem Temesgen",
year = "2012",
month = "2",
doi = "10.1007/s11908-011-0230-8",
language = "English (US)",
volume = "14",
pages = "91--101",
journal = "Current Infectious Disease Reports",
issn = "1523-3847",
publisher = "Current Science, Inc.",
number = "1",

}

TY - JOUR

T1 - HIV in Africa

T2 - Challenges and directions for the next decade

AU - Gilliam, Bruce L.

AU - Patel, Devang

AU - Talwani, Rohit

AU - Temesgen, Zelalem

PY - 2012/2

Y1 - 2012/2

N2 - 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.

AB - 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.

KW - Adherence

KW - Africa

KW - Antiretroviral treatment

KW - Cryptococcus

KW - Early diagnosis

KW - Efficacy

KW - HIV

KW - Male circumcision

KW - Microbicides

KW - Monitoring

KW - Nurse-managed vs. doctor-managed care

KW - Operational research

KW - Preexposure prophylaxis

KW - Residency

KW - Resistance

KW - Resource-limited setting

KW - Scaling-up

KW - Task-shifting

KW - Therapeutic sequencing

KW - Treatment failure

KW - Tuberculosis

KW - Vaccine

KW - Viral load

KW - When to start treatment

KW - Work force

UR - http://www.scopus.com/inward/record.url?scp=84857626331&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84857626331&partnerID=8YFLogxK

U2 - 10.1007/s11908-011-0230-8

DO - 10.1007/s11908-011-0230-8

M3 - Article

C2 - 22143960

AN - SCOPUS:84857626331

VL - 14

SP - 91

EP - 101

JO - Current Infectious Disease Reports

JF - Current Infectious Disease Reports

SN - 1523-3847

IS - 1

ER -