1 / 23

HIV Infection Among Older People in Sub-Saharan Africa

Cape Town October, 2012. HIV Infection Among Older People in Sub-Saharan Africa. Robert Cumming and Joel Negin School of Public Health University of Sydney Australia. A global view of HIV infection 33 million people [ 30–36 million ] living with HIV, 2007.

dannon
Download Presentation

HIV Infection Among Older People in Sub-Saharan Africa

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Cape Town October, 2012 HIV Infection Among Older People inSub-Saharan Africa Robert Cumming and Joel Negin School of Public Health University of Sydney Australia

  2. A global view of HIV infection 33 million people [30–36 million] living with HIV, 2007 Prevalence data is for people aged 15-49 years

  3. JAIDS 2010; 55: 239-244

  4. Causes of Death: Age 50 years and over368 Deaths

  5. Bulletin WHO 2010; 88: 847-853

  6. UNAIDS 2008 Report “Adults in this report are defined as men and women aged 15+ years. This is different from previous reports where the estimates for adults were restricted to 15–49-year-olds. Since the burden of disease extends beyond the age of 49 and to better assess that need, the UNAIDS Reference Group on Estimates, Modelling and Projections has recommended changing the reporting to all ages. The HIV prevalence proportion rate however continues to be for adults 15–49 to allow comparisons across countries.”

  7. Main Findings • 3 million people aged 50 years or older in sub-Saharan Africa are HIV positive (2007) • 14% of all people infected with HIV in sub-Saharan Africa are aged 50 years or older • Prevalence of HIV in people aged 50 years and over is 4%, compared to 5% in people aged 15 to 49 years

  8. HIV Prevalence in Older People in Sub-Saharan Africa, 2007

  9. HIV in Sub-Saharan Africa: 2011 to 2040 Percentage of HIV infected people aged 50 years or older will increase from 13%in 2011 to 27%in 2040 Total number of HIV infected people aged 50 years or older will increase from 3.1 million in 2011 to 9.1 million in 2040 Source: Hontelez JAC et al. AIDS 2012; 26 (Suppl 1): S19-S30

  10. AIDS and Behavior 2012; 16: 63-68

  11. Millennium Villages Study • 9 MV sites in 8 countries • Ghana, Kenya, Malawi, Mali, Nigeria, Rwanda, Senegal, Tanzania • n=2256 • 1534 aged 25-49 • 722 aged 50+ • Questionnaire • Knowledge (6 questions) • Stigma (2 questions) • HIV test

  12. HIV Knowledge Scores in Millennium Villages

  13. HIV Testing in East African MVP Sites

  14. Treatment Outcomes • Uganda (Bakanda et al 2011) • South Africa (Mutevedzi et al 2011) • Malawi (Negin et al 2011)

  15. Survival on ART, TASO, Uganda, 2004-10 n=22,087 Hazard ratio: 1.23 (95% CI 1.08-1.42) Source: Bakanda C et al. AIDS 2011; 25: 701-5

  16. Mortality on ART, rural South Africa, 2004-9 n=8846 Hazard ratio: 1.32 (95% CI 1.09-1.60) Source: Mutevedzi PC et al. Plos ONE 2011;6(7):e21795

  17. Survival on ART, Zomba, Malawi, 2005-10 n=10,900 Hazard ratios 50-59: 1.00 (95% CI 0.79-1.27) 60+: 1.46 (95% CI 1.03-2.06) Source: Negin J et al. Plos ONE 2011;6(10): e26546

  18. Prevalence of HIV and chronic co-morbidities among older adults in South Africa using SAGE nationally representative data Negin J, Martiniuk A, Cumming RG, Naidoo N, Phaswana-Mafuya N, Madurai L, Williams S, Kowal P • AIDS 2012; 26 (Suppl 1)

  19. HIV and NCDs in People Aged 60+South Africa SAGE Study n=1646. HIV prevalence 4%.

  20. Determining the Health Care Needs of Older People Living with HIV in Uganda Kuteesa M, Seeley J, Cumming RG, Negin J African Journal of AIDS Research (in press)

  21. Qualitative Study Setting: Uganda Cares clinics in Kampala and Masaka Subjects: n=40, 4 focus groups (6 per group) and 16 in-depth interviews mean age: 65 years Interviewers: 65 year old woman and 79 year old man (trained by MRC Entebbe)

  22. Some Results • Treated with respect by health care workers • Access problems: travel, clinic architecture, financial cost • Stigma – being old with HIV • Want help with: • Writing wills • Food • General services for older people

  23. Conclusions • HIV and AIDS occur frequently among people aged 50+ in sub-Saharan Africa • The proportion of people with HIV aged 50+ will increase significantly • Older people have poorer knowledge about HIV and are less likely to be tested • Treatment outcomes in people 50-59 on ART are as good as in younger adults • Access to care is difficult for many older people

More Related