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The continuum of HIV care in South Africa: implications for achieving the second and third UNAIDS 90-90-90 targets.
AIDS. 2017 Feb 20; 31(4):545-552.BACKGROUND: We characterize engagement with HIV care in South Africa in 2012 to identify areas for improvement towards achieving global 90-90-90 targets. METHODS: Over 3.9 million CD4 cell count and 2.7 million viral load measurements reported in 2012 in the public sector were extracted from the national laboratory electronic database. The number of persons living with HIV (PLHIV), number and proportion in HIV care, on antiretroviral therapy (ART) and with viral suppression (viral load <400 copies/ml) were estimated and stratified by sex and age group. Modified Poisson regression approach was used to examine associations between sex, age group and viral suppression among persons on ART. RESULTS: We estimate that among 6511 000 PLHIV in South Africa in 2012, 3300 000 individuals (50.7%) accessed care and 32.9% received ART. Although viral suppression was 73.7% among the treated population in 2012, the overall percentage of persons with viral suppression among all PLHIV was 23.8%. Linkage to HIV care was lower among men (38.5%) than among women (57.2%). Overall, 47.1% of those aged 0-14 years and 47.0% of those aged 15-49 years were linked to care compared with 56.2% among those aged above 50 years. CONCLUSION: Around a quarter of all PLHIV have achieved viral suppression in South Africa. Men and younger persons have poorer linkage to HIV care. Expanding HIV testing, strengthening prompt linkage to care and further expansion of ART are needed for South Africa to reach the 90-90-90 target. Focus on these areas will reduce the transmission of new HIV infections and mortality in the general population.
Chinese Journal of Health Education. 2003 Jun; 19(6):457-458.The concept of reproductive health is a new one first advanced by World Health Organization (WHO) human health research plan chairman Barzelatto in 1988. In 1994 the WHO Global Policy Council formally adopted a definition of reproductive health; in 1995 the World Health Congress again stressed the importance of the WHO’s global reproductive health strategy, and proposed an international health struggle goal of “universal access to reproductive health by 2015.” The definition and scope of reproductive health. Reproductive health is a physical, mental and social state of well being, but not only a lack of sickness or debilitation. The particular scope includes having a healthy and harmonious sexual physiology and a regular sex life, free from worry of sexually transmitted disease or unwanted pregnancy; people having the ability to have children, but also having scientific adjustments and control of their own reproduction, to freely decide whether to have children, when to have children and how many to have. It requires that the sexes have equal rights to knowledge to make safe, effective and responsible choices; access to methods of reproductive control; use of appropriate health services; safe and comfortable pregnancy and childbirth, with the best opportunity for the mother and infant’s health. Important contents of reproductive health: sexually mature sperm, ovum, pregnancy, period of nursing after birth, regulation of fertility, cure of infertility, reproductive infection and prevention of disease. (excerpt)
Forced Migration Review. 2004 Jan; (19):16-18.Every year more than half a million women die from complications of pregnancy and childbirth. Many more suffer severe disabilities. WHO estimates that 15% of all pregnant women will develop direct obstetric complications such as haemorrhage, obstructed or prolonged labour, pre-eclampsia or eclampsia, sepsis, ruptured uterus, ectopic pregnancy and complications of abortion. If left untreated, they will lead to death or severe disability. Maternal mortality and morbidity can only be reduced by ensuring women with obstetric complications receive good-quality medical treatment without delay. The desperate circumstances of refugee and IDP women fleeing conflict place them at exceptional risk of pregnancy-related death, illness and disability. The target of reducing maternal mortality by 75% by 2015 is a key UN Millennium Development Goal. Because obstetric complications cannot be predicted or prevented, all pregnant women need access to good quality EmOC. (excerpt)
In: Eye to eye, [compiled by] International Planned Parenthood Federation [IPPF]. London, England, IPPF, 2001. 16-21.Through the use of clinics, youth centers, retail outlets, integrated facilities and other means, International Planned Parenthood Federation (IPPF) is ensuring that for the first time in many countries, young people can now access youth- friendly sexual and reproductive health services designed for young people where no other organization is providing them. There are a number of strategies to attract young people to services or to take services to young people but in each case the factors for success are linked to quality and the attributes of youth friendliness. IPPF affiliates have also shown how a broader approach to youth development can be used to achieve sexual and reproductive health related goals. (excerpt)