Accessibility and use of ART among South African population, 2017

  • Viral hepatitis and HIV
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Background:
In 2017, an estimated 7.9 million people were living with HIV (PLHIV) in South Africa (SA), of whom 4.4 million (56%) were receiving antiretroviral treatment (ART). Factors leading to underutilization of ART include people not knowing their HIV status, stigmatization, and socio-demographic factors. In order to achieve universal ART cover- age, these factors need to be identified and addressed. We investigate the accessibility and use of ART among South Africans.
Methods:
Data were analyzed from the fifth South African National HIV Prevalence, Incidence and Behaviour survey; a cross- sectional household survey conducted between 2016–2017 in SA. We analyzed factors associated with ART non-use among PLHIV. Logistic regression analysis was performed to determine the association between ART non-use and selected demographic, socioeconomic, and behavioural variables.
Results:
A greater proportion of females living with HIV [65.5% (95% confidence interval (CI): 62.3–68.5)] accessed treatment than males [56.3% (95%CI: 51.0–61.5)]. Half of the children aged 0–14 years living with HIV were on ART. KwaZulu-Natal Province had the highest proportion of people accessing ART, more evident in females [71.8% (95% CI: 64.2–78.3)] than males [65.7% (95%CI: 55.3–74.8)]. On multivariate regression analysis, being aged 35–49 years [adjusted odds ratio (aOR) 3.51 (95% CI: 2.31–5.32) p<0.001] and 50–64 years [aOR 5.05 (95% CI: 2.99–8.54) p<0.001] was significantly associated with ART non-use. People living in rural areas [aOR 1.70 (95% CI: 1.26–2.29) p=0.001] were less likely to use ART compared to those in urban areas.
Conclusion
Our Results: suggest that despite increasing use of ART over the years, there is a gap in treatment coverage for those aged 35 years and older. There is also a need to encourage and educate people living in rural areas about the importance and benefits of knowing their status and being on treatment.

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