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https://studentshare.org/health-sciences-medicine/1440787-on-going-treatment-to-reduce-hiv-aids-in-south.
Introduction & brief overview
Sub-Saharan Africa is currently described as the epicenter of the human immunodeficiency virus and acquired immune disease syndrome (UNAIDS & WHO 2006) with an estimated 25 million currently infected individuals. (Varga & Brookes 2008). In South Africa, specific or accurate data is not easy to find, but Baptiste et al. have found that the prevalence of HIV/AIDS in the adolescent population is in the region of 15% (Baptiste, Bhana, Petersen, McKay, Voisin, et al. 2006)
The HIV/AIDS epidemic is currently the leading cause of death in sub-Saharan Africa with the UNAIDS report noting 1.7 million deaths amongst adults in 2008. (UNAIDS 2008)
The impact of Antiretroviral Therapy
Antiretroviral therapy (henceforth ART) has been a major milestone in the progress against the spread of HIV/AIDS. Anema et al. (2011), in their assessment of the medical and socio-economic impact of the epidemic, point out that HIV/AIDS has orphaned nearly 12 million young children in sub-Saharan Africa, many of these in South Africa. It is hoped that with the increasing availability of ART, there is expected to be a reduction in the incidence of orphanhood amongst children by decreasing the mortality of the adult population and reducing the overall incidence of HIV transmission across the population. The same authors go on to attempt to predict what the possible effects of this increasing use of antiretroviral therapy might be, using demographic modeling to make predictions based on information on population and HIV incidence taken from UNAIDS, UN Population Division, and WHO statistics. They found that, if current trends and observations can be directly extrapolated across the population, the current proposed expansion of antiretroviral therapy intervention could avert more than 4.3 million cases of HIV/AIDS-related orphanhood by the year 2020, with the majority of these (nearly 1 million) being in South Africa (Anema et al., 2011). Clearly, there are a large number of assumptions that were made in support of this estimate however, it was concluded that an intervention aimed at expanding the availability and uptake of antiretroviral therapy by a realistic and achievable level would significantly decrease adult mortality across sub-Saharan Africa and significantly reduce the incidence of orphanhood in this region with all of the personal, and socio-economic benefits that would bring.