Accessibility and use of ART among South African population, 2017

  • Viral hepatitis and HIV
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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.
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.
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.
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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