Strengthening HIV surveillance in the antiretroviral therapy era : rationale and design of a longitudinal study to monitor HIV prevalence and incidence in the uMgungundlovu District, KwaZulu-Natal, South Africa

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dc.contributor.authorKharsany, Ayesha B. M.en_ZA
dc.contributor.authorCawood, Cherieen_ZA
dc.contributor.authorKhanyile, Daviden_ZAe
dc.contributor.authorGrobler, Annekeen_ZA
dc.contributor.authorMckinnon, Lyle R.en_ZA
dc.contributor.authorSamsunder, Natashaen_ZA
dc.contributor.authorFrohlich, Janet A.en_ZA
dc.contributor.authorKarim, Quarraisha Abdoolen_ZA
dc.contributor.authorPuren, Adrianen_ZA
dc.contributor.authorWelte, Alexen_ZA
dc.contributor.authorGeorge, Gavinen_ZA
dc.contributor.authorGovender, Kaymarlinen_ZA
dc.contributor.authorToledo, Carlosen_ZA
dc.contributor.authorChipeta, Zawadien_ZA
dc.contributor.authorZembe, Lyciasen_ZA
dc.contributor.authorGlenshaw, Mary T.en_ZA
dc.contributor.authorMadurai, Lornaen_ZA
dc.contributor.authorDeyde, Varough M.en_ZA
dc.contributor.authorBere, Alfreden_ZA
dc.date.accessioned2016-11-11T10:18:37Z
dc.date.available2016-11-11T10:18:37Z
dc.date.issued2015
dc.descriptionCITATION: Kharsany, A. B. M., et al. 2015. Strengthening HIV surveillance in the antiretroviral therapy era : rationale and design of a longitudinal study to monitor HIV prevalence and incidence in the uMgungundlovu District, KwaZulu-Natal, South Africa. BMC Public Health, 15:1149, doi:10.1186/s12889-015-2179-2.
dc.descriptionThe original publication is available at http://bmcpublichealth.biomedcentral.com
dc.description.abstractBackground: South Africa has over 6,000,000 HIV infected individuals and the province of KwaZulu-Natal (KZN) is the most severely affected. As public health initiatives to better control the HIV epidemic are implemented, timely, detailed and robust surveillance data are needed to monitor, evaluate and inform the programmatic interventions and policies over time. We describe the rationale and design of the HIV Incidence Provincial Surveillance System (HIPSS) to monitor HIV prevalence and incidence. Methods/Design: The household-based survey will include a sample of men and women from two sub-districts of the uMgungundlovu municipality (Vulindlela and the Greater Edendale) of KZN, South Africa. The study is designed as two sequential cross-sectional surveys of 10,000 randomly selected individuals aged 15 – 49 years to be conducted one year apart. From the cross sectional surveys, two sequential cohorts of HIV negative individuals aged 15 – 35 years will be followed-up one year later to measure the primary outcome of HIV incidence. Secondary outcomes include the laboratory measurements for pulmonary tuberculosis, sexually transmitted infections and evaluating tests for estimating population-level HIV incidence. Antiretroviral therapy (ART) access, HIV-1 RNA viral load, and CD4 cell counts in HIV positive individuals will assess the effectiveness of the HIV treatment cascade. Household and individual-level socio-demographic characteristics, exposure to HIV programmatic interventions and risk behaviours will be assessed as predictors of HIV incidence. The incidence rate ratio of the two cohorts will be calculated to quantify the change in HIV incidence between consecutive samples. In anticipation of better availability of population-level HIV prevention and treatment programmes leading to decreases in HIV incidence, the sample size provides 84 % power to detect a reduction of 30 % in the HIV incidence rate between surveys. Discussion: The results from HIPSS will provide critical data regarding HIV prevalence and incidence in this community and will establish whether HIV prevention and treatment efforts in a “ real world ” , non-trial setting have an impact on HIV incidence at a population level. Importantly, the study design and methods will inform future methods for HIV surveillance.en_ZA
dc.description.urihttp://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-2179-2
dc.description.versionPublisher's version
dc.format.extent11 pages
dc.identifier.citationKharsany, A. B. M., et al. 2015. Strengthening HIV surveillance in the antiretroviral therapy era : rationale and design of a longitudinal study to monitor HIV prevalence and incidence in the uMgungundlovu District, KwaZulu-Natal, South Africa. BMC Public Health, 15:1149, doi:10.1186/s12889-015-2179-2
dc.identifier.issn1471-2458 (online)
dc.identifier.otherdoi:10.1186/s12889-015-2179-2
dc.identifier.urihttp://hdl.handle.net/10019.1/99839
dc.language.isoen_ZAen_ZA
dc.publisherBioMed Central
dc.rights.holderAuthors retain copyright
dc.subjectHIV-infected personsen_ZA
dc.subjectHIV infections -- South Africa -- Kwazulu-Natalen_ZA
dc.subjectHIV infections -- Prevention -- Statisticsen_ZA
dc.subjectHIV infections -- Treatment -- Statisticsen_ZA
dc.titleStrengthening HIV surveillance in the antiretroviral therapy era : rationale and design of a longitudinal study to monitor HIV prevalence and incidence in the uMgungundlovu District, KwaZulu-Natal, South Africaen_ZA
dc.typeArticleen_ZA
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