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Africa: Studies reveal impact of large-scale ART programmes on viral suppression

Friday, 7 March, 2014

Médecins Sans Frontières research presented at the Conference on Retroviruses and Opportunistic Infections (CROI) this week indicates the success of large-scale antiretroviral therapy (ART) programmes in high HIV prevalence settings in Africa. Two studies in Malawi and South Africa provide crucial on-the ground evidence of the impact of these programmes on reducing new HIV infections among the community. They demonstrate that high levels of viral suppression, meaning that HIV is considered ‘undetectable’, are possible in low-resource settings through effective roll-out of ART targeting areas with a high HIV burden.

The Malawi study took place in an area with an estimated HIV prevalence of 17 percent and good ART coverage of 65.8 percent. The incidence rate – the number of new HIV infections – proved to be very low (0.4 percent) among those surveyed, which included both people on ART and those not, and a large number (61.8 percent) had undetectable levels of HIV in their blood. While the South African study was conducted in a region with very high HIV prevalence (25 percent) where around two thirds of people in need of treatment are on ART. Results revealed that 89.6 percent of people who had been taking ART for six months were virally suppressed; meaning the risk of them transmitting the virus to others is very low.

This research has important implications as it provides much-needed ‘real-life’ evidence of the efficacy of large-scale treatment programmes in resource-poor areas. It also provides insight into the importance of targeting specific groups to ensure universal access to treatment in high-burden settings.