1 / 17

Enhanced Monitoring of HIV/AIDS in South Asia

Enhanced Monitoring of HIV/AIDS in South Asia. International Studies of HIV/AIDS (ISHA) Research Group:

pavel
Download Presentation

Enhanced Monitoring of HIV/AIDS in South Asia

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. Enhanced Monitoring of HIV/AIDS in South Asia International Studies of HIV/AIDS (ISHA) Research Group: Paul Arora, Rajesh Kumar, Prabhat Jha, Neeraj Dhingra, Prem Mony, Prakash Bhatia, Peggy Millson, Li Chen, Madhulekha Bhattacharya, Robert Remis, Sema Sgaier, PV Lakshmi, Nico Nagelkerke, Mariam Claeson Centre for Global Health Research, St. Michael’s Hospital, University of Toronto, Canada Prabhat.jha@utoronto.ca

  2. Summary • Enhanced independent monitoring focusing on programs (vs projects) that is simple, routine, reliable, low-cost, long-term is needed to evaluate the success of HIV/AIDS control programs (including of “universal access”). • Key pillars include: (a) understanding sexual networks, esp. of males; (b) enhanced ANC and STI surveillance; (d) mortality measurement; (d) transparent modelling; and (e) capacity building in countries. • A multi-country effort to implement these pillars is urgently needed, and would be a low-cost, high-impact activity. Source: Authors, 2006

  3. Source: Kumar et al, Lancet 367 (2006)

  4. FEMALES-Summary ORs of all risk factors Meta-analyses of 79 epidemiological studies in Africa Source: Chen et al, forthcoming

  5. MALES- Summary ORs of all risk factors: Meta-analyses of 79 epidemiological studies in Africa Source: Chen et al, forthcoming

  6. Source: Chen et al, forthcoming

  7. <0/5% 0.5% to <1% 1% to <1.5% >=1.5% Regions of analysis • Maximum state-level HIV-1 seroprevalence among ANC attendees from1998 to 2003 • Two regions of analysis : • South • North and other Source: Kumar et al, Lancet 367 (2006)

  8. Source: Kumar et al, Lancet 367 (2006)

  9. Figure 5: Age-standardised HIV-1 prevalence in men aged 20–29 years attending STI clinics in 2000–04, and in those with genital ulcers in the south and north of India HIV-positive/tested=number of HIV-positive individuals/number of individuals tested. Boxes and lines are prevalence and 95% CI. Source: Kumar et al, Lancet 367 (2006)

  10. Sum: 1/3 decline in South: • Not due to major changes in women who go to pregnancy clinics • Not due to changes in sites chosen • Not due to mortality • Only changes in husband’s use of female sex work (less often or with condoms when done) is only plausible explanation • Consistent with increased peer intervention programs to reach sex workers starting about 1999 • Gaps exist in South however: esp. Karnataka and Andhra Pradesh • Goal: 100% coverage in each of 115 districts Source: Kumar, Jha, Arora et al; 2006

  11. United Kingdom: AIDS treatment, deaths and STI trends among males having sex with males % MSM ON ARV AIDS DEATHS TRENDS IN GONORRHEA Source: Murphy, G. et. al. AIDS 2004, 18:

  12. Proportion of urban TB to total deathsby high HIV state (AP, KN, MH, TN) and other states, 1990-2000 Source: Jha et al, forthcoming

  13. AIDS mortality in IndiaPreliminary results of the RGI-CGHR Million Death Study (n=150,000 deaths 2001-3, 22,000 analyzed here)(All cause deaths at ages 15-59 total 3,772,000) Source: Jha et al, forthcoming

  14. HIV-1 prevalence (adults aged 15-59) projections in India: past and current estimates Source: Jha et al, forthcoming

  15. Source: Jha et al, forthcoming

  16. Summary • Enhanced independent monitoring focusing on programs (vs. projects) that is simple, routine, reliable, low-cost, long-term is needed to evaluate the success of HIV/AIDS control programs (including of “universal access”). • Key pillars include: (a) understanding sexual networks, esp. of males; (b) enhanced ANC and STI surveillance; (d) mortality measurement; (d) transparent modelling; and (e) capacity building in countries. • A multi-country effort to implement these pillars is urgently needed, and would be a low-cost, high-impact activity. Source: Authors, 2006

More Related