Original Research

Progress towards the 2020 targets for HIV diagnosis and antiretroviral treatment in South Africa

Leigh F. Johnson, Rob E. Dorrington, Haroon Moolla
Southern African Journal of HIV Medicine | Vol 18, No 1 | a694 | DOI: https://doi.org/10.4102/sajhivmed.v18i1.694 | © 2017 Leigh F. Johnson, Rob E. Dorrington, Haroon Moolla | This work is licensed under CC Attribution 4.0
Submitted: 21 September 2016 | Published: 27 July 2017

About the author(s)

Leigh F. Johnson, Centre for Infectious Disease Epidemiology and Research, University of Cape Town, South Africa
Rob E. Dorrington, Centre for Actuarial Research, University of Cape Town, South Africa
Haroon Moolla, Centre for Infectious Disease Epidemiology and Research, University of Cape Town, South Africa

Abstract

Background: The UNAIDS targets for 2020 are to achieve a 90% rate of diagnosis in HIVpositive individuals, to provide antiretroviral treatment (ART) to 90% of HIV-diagnosed individuals and to achieve virological suppression in 90% of ART patients.

Objectives: To assess South Africa’s progress towards the 2020 targets and variations in performance by province.

Methods: A mathematical model was fitted to HIV data for each of South Africa’s provinces, and for the country as a whole. Numbers of HIV tests performed in each province were estimated from routine data over the 2002–2015 period, and numbers of patients receiving ART in each province were estimated by fitting models to reported public and private ART enrolment statistics.

Results: By the middle of 2015, 85.5% (95% CI: 84.5% – 86.5%) of HIV-positive South African adults had been diagnosed, with little variation between provinces. However, only 56.9% (95% CI: 55.3% – 58.7%) of HIV-diagnosed adults were on ART, with this proportion varying between 50.8% in North West and 72.7% in Northern Cape. In addition, 78.4% of adults on ART were virally suppressed, with rates ranging from 69.7% in Limpopo to 85.9% in Western Cape. Overall, 3.39 million (95% CI: 3.26–3.52 million) South Africans were on ART by mid- 2015, equivalent to 48.6% (95% CI: 46.0% – 51.2%) of the HIV-positive population. ART coverage varied between 43.0% in Gauteng and 63.0% in Northern Cape.

Conclusion: Although South Africa is well on its way to reaching the 90% HIV diagnosis target, most provinces face challenges in reaching the remaining two 90% targets.


Keywords

HIV/AIDS; antiretroviral treatment; HIV diagnosis; South Africa

Metrics

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61. Perioperative care to patients living with HIV by theatre nurses at a South African tertiary hospital
Rudzani Ifodia Ngaledzani, Avhatakali Allga Ndou-Mammbona, Azwihangwisi Helen Mavhandu-Mudzusi
F1000Research  vol: 11  first page: 1299  year: 2024  
doi: 10.12688/f1000research.125582.2

62. The impact of the South African antiretroviral treatment programme on the age-standardised incidence rate of Kaposi sarcoma, 1999–2016: An interrupted time series analysis
Evidence Majaya, Brendan V. Girdler-Brown, Mazvita Muchengeti, Elvira Singh
International Journal of Infectious Diseases  vol: 102  first page: 20  year: 2021  
doi: 10.1016/j.ijid.2020.10.020

63. Geo-analysis: the distribution of community health workers in relation to the HIV prevalence in KwaZulu-Natal province, South Africa
G. E. Khumalo, S. Ntuli, E. Lutge, T. P. Mashamba-Thompson
BMC Health Services Research  vol: 22  issue: 1  year: 2022  
doi: 10.1186/s12913-022-07707-x

64. A quantitative assessment of the consistency of projections from five mathematical models of the HIV epidemic in South Africa: a model comparison study
Haroon Moolla, Andrew Phillips, Debra ten Brink, Edinah Mudimu, John Stover, Loveleen Bansi-Matharu, Rowan Martin-Hughes, Nisaa Wulan, Valentina Cambiano, Jennifer Smith, Anna Bershteyn, Gesine Meyer-Rath, Lise Jamieson, Leigh F. Johnson
BMC Public Health  vol: 23  issue: 1  year: 2023  
doi: 10.1186/s12889-023-16995-9

65. Effective public-private partnerships for sustainable antiretroviral therapy: outcomes of the Right to Care health services GP down-referral program
Idah Mokhele, Sello Mashamaite, Pappie Majuba, Thembi Xulu, Lawrence Long, Dorina Onoya
BMC Public Health  vol: 19  issue: 1  year: 2019  
doi: 10.1186/s12889-019-7660-x

66. Cohort profile: the South African HIV Cancer Match (SAM) Study, a national population-based cohort
Mazvita Muchengeti, Lina Bartels, Victor Olago, Tafadzwa Dhokotera, Wenlong Carl Chen, Adrian Spoerri, Eliane Rohner, Lukas Bütikofer, Yann Ruffieux, Elvira Singh, Matthias Egger, Julia Bohlius
BMJ Open  vol: 12  issue: 4  first page: e053460  year: 2022  
doi: 10.1136/bmjopen-2021-053460

67. Quantifying the HIV treatment cascade in a South African health sub‐district by gender: retrospective cohort study
Mark N. Lurie, Kipruto Kirwa, Julia Callaway, Morna Cornell, Andrew Boulle, Angela M. Bengtson, Mariette Smith, Natalie Leon, Christopher Colvin
Tropical Medicine & International Health  vol: 25  issue: 2  first page: 186  year: 2020  
doi: 10.1111/tmi.13334

68. Changing Patterns of Lymphoma in the Antiretroviral Therapy Era in Johannesburg, South Africa
Tracey Wiggill, Elizabeth Mayne, Yvonne Perner, Jenifer Vaughan
JAIDS Journal of Acquired Immune Deficiency Syndromes  vol: 88  issue: 3  first page: 252  year: 2021  
doi: 10.1097/QAI.0000000000002768

69. IAPAC–Lancet HIV Commission on the future of urban HIV responses
José M Zuniga, Corey Prachniak, Nicoletta Policek, Nombulelo Magula, Anisha Gandhi, Jane Anderson, Dázon Dixon Diallo, Viviane Dias Lima, Sindhu Ravishankar, Shrikala Acharya, Angeli Achrekar, Monsurat Adeleke, Élodie Aïna, Solange Baptiste, Geoffrey Barrow, Josip Begovac, Elizabeth Bukusi, Amanda Castel, Erika Castellanos, Jorge Cestou, Gertrude Chirambo, Jeffrey Crowley, Nikos Dedes, Lucica Ditiu, Meg Doherty, Chris Duncombe, Adriana Durán, Donna Futterman, Shannon Hader, Chyrol Kounkeu, Fran Lawless, Jeffrey V Lazarus, Sabine Lex, Carlos Lobos, Kenneth Mayer, Maria Mejia, H Rodrigo Moheno, Antonella d'Arminio Monforte, Mónica Morán-Arribas, Daniel Nagel, Robert Ndugwa, Carol Ngunu, Midnight Poonkasetwattana, Maria Prins, Amara Quesada, Olga Rudnieva, Simon Ruth, Jorge Saavedra, Lance Toma, Lucy Wanjiku Njenga, Brian Williams
The Lancet HIV  vol: 11  issue: 9  first page: e607  year: 2024  
doi: 10.1016/S2352-3018(24)00124-3

70. The fall—And rise—In hospital-based care for people with HIV in South Africa: 2004–2017
Evelyn Lauren, Khumbo Shumba, Matthew P. Fox, William MacLeod, Wendy Stevens, Koleka Mlisana, Jacob Bor, Dorina Onoya, Claudia P. Cortes
PLOS Global Public Health  vol: 4  issue: 9  first page: e0002127  year: 2024  
doi: 10.1371/journal.pgph.0002127

71. Achieving the fast track 90-90-90 and 95-95-95 targets in sub-Saharan Africa: A rapid review
Celenkosini T. Nxumalo, Usangiphile Buthelezi, Hlolisile Chiya, Mokgadi U. Makgobole, Nomakhosi Mpofana, Themba Mgwaba, Zamasomi Luvuno
Journal of Public Health in Africa  vol: 16  issue: 1  year: 2025  
doi: 10.4102/jphia.v16i1.691

72. Measuring retention in HIV care: the impact of data sources and definitions using routine data
Tamsin K. Phillips, Catherine Orrell, Kirsty Brittain, Allison Zerbe, Elaine J. Abrams, Landon Myer
AIDS  vol: 34  issue: 5  first page: 749  year: 2020  
doi: 10.1097/QAD.0000000000002478

73. “Patients Are Not Following the [Adherence] Club Rules Anymore”: A Realist Case Study of the Antiretroviral Treatment Adherence Club, South Africa
Ferdinand C. Mukumbang, Bruno Marchal, Sara Van Belle, Brian van Wyk
Qualitative Health Research  vol: 28  issue: 12  first page: 1839  year: 2018  
doi: 10.1177/1049732318784883

74. A review of the management and outcome of patients admitted with cryptococcal meningitis at a regional hospital in KwaZulu-Natal province
Andrew J Ross, Egide Ndayishimiye
South African Family Practice  vol: 61  issue: 4  first page: 159  year: 2019  
doi: 10.1080/20786190.2019.1607480

75. Cost-effectiveness of Routine Provider-Initiated Testing and Counseling for Children With Undiagnosed HIV in South Africa
Tijana Stanic, Nicole McCann, Martina Penazzato, Clare Flanagan, Shaffiq Essajee, Kenneth A Freedberg, Meg Doherty, Nande Putta, Landon Myer, George K Siberry, Intira Jeannie Collins, Lara Vojnov, Elaine Abrams, Djøra I Soeteman, Andrea L Ciaranello
Open Forum Infectious Diseases  vol: 9  issue: 1  year: 2022  
doi: 10.1093/ofid/ofab603

76. Spatiotemporal modelling and mapping of cervical cancer incidence among HIV positive women in South Africa: a nationwide study
Dhokotera Tafadzwa, Riou Julien, Bartels Lina, Rohner Eliane, Chammartin Frederique, Johnson Leigh, Singh Elvira, Olago Victor, Sengayi-Muchengeti Mazvita, Egger Matthias, Bohlius Julia, Konstantinoudis Garyfallos
International Journal of Health Geographics  vol: 20  issue: 1  year: 2021  
doi: 10.1186/s12942-021-00283-z