Where is hivaids most common in africa

Prevalence in Uganda may have peaked in the percent range in the early s before the onset of this decline. Elsewhere, Somalia, Eritrea, Djibouti, and Sudan have little or no data, and Madagascar remains an interesting case. Despite tourism, an active commercial sex trade, and high rates of other sexually transmitted infections STIs , and despite being separated from the African mainland by only 60 kms of water, adult HIV prevalence remains below 1 percent.

Angola has been war-torn and chaotic for so long that it is difficult to know exactly what is transpiring with the epidemic there. Among the 15 countries of West Africa, 9 only a few countries have prevalence rates over 5 percent. These include Burkina Faso 6. With an estimated population of million, Nigeria is the demographic giant of sub-Saharan Africa.

If the African epidemic has its roots in the Great Lakes region, the epicenter could well have moved westward into middle and western Africa.

Instead, it moved primarily southward. The question is an intriguing one and no consensus has emerged in response. Cultural and social norms may have played a role.

Demographers John and Pat Caldwell suggest at least two additional factors. They point out that the presence of other STIs is probably the single most important factor contributing to the rapid spread of HIV.

However, it is not all STIs, but especially those that cause genital ulcers that serve as an effective conduit of HIV. The most advanced stage of HIV infection is acquired immunodeficiency syndrome AIDS , which can take from two to 15 years to develop, depending on the individual. Antiretroviral therapy does not cure HIV infection but suppresses viral replication within a person's body and allows an individual's immune system to strengthen and regain the capacity to fight off infections.

In , WHO released the second edition of the Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. These guidelines recommend providing lifelong ART to all people living with HIV, including children, adolescents and adults, pregnant and breastfeeding women, regardless of clinical status or CD4 cell count.

In addition, one in three people living with HIV presents to care with advanced disease, low CD4 count and at high risk of serious illness and death. Expanding access to treatment is at the heart of a set of targets for which aim to bring the world on track to end the AIDS epidemic by The actions proposed include prioritizing HIV prevention, expanding HIV testing services using diversified approaches and scaling up antiretroviral therapy by adopting innovative service delivery models.

Key populations include: men who have sex with men, people who inject drugs, people in prisons and other closed settings, sex workers and their clients, and transgender people. They are at increased risk of HIV infection irrespective of epidemic type or local context. Key populations often face legal and social barriers that increase their vulnerability to HIV and impede their access to prevention, testing and treatment programmes.

These populations historically have not received adequate priority in the response to the HIV epidemic, especially in countries with generalized HIV epidemics. In the African Region, these populations face structural barriers to services that compound their risk exposure — barriers such as laws that criminalize their behaviour, stigma, discrimination and violence.

The gaps are particularly evident for transgender people, people who inject drugs and prisoners. Overall, national strategic plans pay little specific attention to young members of key populations. WHO Regional Offices will create additional regionspecific messages and materials under the global theme. Download the full infographic. HIV continues to be a major global public health issue, having claimed more than 35 million lives so far.

In , some people died from HIV-related causes globally. The number of new HIV infections continues to decline. However, the progress is much slower than what is required to reach the targets for In , there were an estimated 1. Of that number, In addition, viral suppression helps prevent transmission to others through sex, needle sharing and from mother to child during pregnancy, birth and breastfeeding. The symptoms of HIV vary depending on the stage of infection. Though people living with HIV tend to be most infectious in the first few months, many are unaware of their status until later stages.

In the first few weeks after initial infection, individuals may experience no symptoms or an influenza-like illness including fever, headache, rash, or sore throat. As the infection progressively weakens the immune system, an individual can develop other signs and symptoms, such as swollen lymph nodes, weight loss, fever, diarrhoea and cough.

Without treatment, they could also develop severe illnesses such as tuberculosis, cryptococcal meningitis, severe bacterial infections and cancers such as lymphomas and Kaposi's sarcoma, among others.

HIV can be transmitted via the exchange of a variety of body fluids from infected individuals, such as blood, breast milk, semen and vaginal secretions. Individuals cannot become infected through ordinary day-to-day contact such as kissing, hugging, shaking hands, or sharing personal objects, food or water.

HIV infection can be detected with great accuracy, using WHO prequalified tests within a validated approach. It is important that these tests be used in combination and in a specific order that has been validated and is based on HIV prevalence of the population being tested. Although some countries like Nigeria or Ethiopia have made important research efforts, with corresponding increases in their scientific productivity, different studies have highlighted the need for increasing ties with neighboring countries.

This would enable a more fluid exchange of knowledge and experience and foster research in key areas like detection and treatment [ 11 , 24 ]. These two features may reflect a certain scientific dependence and subordination among African countries in relation to more developed countries. Moreover, the same situation has been observed in other biomedical research fields that are of special importance to the global South, like tropical diseases, infectious diseases, and pediatrics [ 22 , 25 , 26 ].

More specifically, Kelaher et al. Finally, among first authors from all LMICs worldwide, those from Africa authored fewer papers than those from other regions like Latin America or Asia.

The literature describes different barriers that hinder researchers in LMICs from assuming leadership roles. Some of these are related to the absence of infrastructures or adequate financing [ 28 ]. Without an established institutional framework, stable research groups cannot be created or sustained; researchers cannot access the technical and financial support they need to submit research tenders; and coordination and monitoring of research priorities in relation to local research agendas is inadequate [ 13 , 29 , 30 , 31 ].

Other barriers have to do with deficits in methodological skills like research design and statistical interpretation or language composition of articles or fluency in English. At the same time, there are structural factors related to the hub-and-spoke model that favor the increased recognition and success of countries conducting mainstream research. Economic and human resources are concentrated in North America and Europe, and these regions also establish priority research topics. Editorial bias and the Matthew effect of accumulated advantage cement the structural forces perpetuating the under-representation of researchers from the global South from assuming positions of leadership in scientific publications [ 26 , 32 ].

The former stands out for the high number of collaborative links it has established, with its researchers co-authoring papers with most African and Middle Eastern countries 52 countries. Our own group have highlighted this role in other biomedical research fields [ 37 ]. Nachega et al. A similar phenomenon has also been observed in other fields of the health sciences, such as infectious diseases [ 15 , 38 ].

In addition to maintaining important collaborative ties with the USA and different European countries [ 39 , 40 ], South Africa has also emerged as a hub for intraregional collaborations within Africa.

It has established links with 35 countries—far more than other African countries. In that sense, some papers have called for BRICS countries, including South Africa, to increase their efforts to tackle the challenges primarily affecting the developing world [ 19 ]. In the case of South Africa, this could be done by promoting intraregional collaborations in sub-Saharan Africa, as research undertaken at a local level has the most potential to produce benefits, both for population health and socioeconomic development [ 20 , 41 ].

The literature highlights specific barriers impeding equitable research collaboration for African researchers, for example the paper by Okeke [ 43 ], who pointed to the limited duration of research programs, which should be longer in order to nurture stable collaborations that build hard and leadership capacities. In addition to infrastructure, other aspects mentioned include managerial expertise, administrative capabilities, and the capacity to improvise at African partner institutions.

This finding indicates the need to consider regional, national, and local specificities and interests when determining research priorities. From a public health perspective, for example, Uthman [ 11 ] pointed out the need for further research evidence to inform HIV prevention and control programs.

In this field, some countries perform better than others: South Africa is particularly strong in public health research [ 50 ], while other African countries and regions, such as French Africa, have made limited contributions [ 51 ].

However, these authors argued for moving epidemiology and public health research beyond the limited sphere of communicable disease control in order to address the regional impact of non-communicable diseases, for example in maternal and child health. The study also calls for strengthening regional expertise in epidemiology in order to shed light on the underlying causes of ill health, rather than to merely control infections and outbreaks [ 16 ].

One possible explanation for this includes the fact that women are more biologically, economically, socially, and culturally vulnerable to infection. In consonance with this fact, a greater number of women participate and work on HIV care programs in Africa, and a large proportion of the clinicoepidemiological investigations in these settings are based on care program data [ 52 ].

These epidemiological patterns are less important in Africa [ 53 ]. The prominence of topics related to preventing mother-to-child transmission stands in contrast to the near absence of topics related to children and young people. These groups are especially sensitive to the physical and psychosocial impacts of HIV and AIDS, indicating the need for increased research on young people who are at risk of or living with HIV [ 55 ].

The greater research attention to topics related to public health, epidemiology, and treatment may also respond to limited laboratory capacity, which is needed for virologic, immunological, and basic research. In that sense, it is essential to promote initiatives that strengthen these research structures and capacities in African countries, rather than only supporting programs and projects on preventive and clinical approaches.

Moreover, using the MeSH thesaurus from the field of health sciences could have resulted in an underestimation of research spheres related to our subject area, such as research in the social sciences.

Furthermore, the use of first author status as a proxy for African leadership may be misleading, as an African senior author may be the last author on a publication or may have played a leadership role in some aspects other than the manuscript preparation.

Our study focused on obtaining macro indicators on scientific collaboration and output by regions and countries. It would also be of great interest to identify the organisms or programs that have funded the research inspiring the publications about HIV, measuring resource contributions according to domestic versus international as well as public versus private origins.

Despite these advances, however, scientific output is still concentrated in a small number of countries, chief among them South Africa, while other countries in Africa and the Middle East make only negligible contributions, despite the high burden of HIV infections. Collaborations between these regions reflect limited leadership by African countries, as measured by the participation of African researchers as the first authors of published studies.

To achieve this balance, it is necessary to transfer research skills to African partners, promote equitable collaborative ties, and empower African countries, especially those with less scientific activity and more disease prevalence.

In the same way, the lack of investment in research infrastructure by African governments likely makes it more difficult for African investigators to lead their own research.

Intraregional collaborations among African countries can also help to avoid the further concentration of research capacity, reproducing the global North-South model on the African continent. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, — the global burden of disease study Lancet HIV.

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