Rédaction Africa Links 24 with Jen Manne-Goehler, Physician-scientist, Harvard T.H. Chan School of Public Health
Published on 2024-02-18 07:07:22
South Africa has a high prevalence of HIV among all age groups, with about 8.2 million people, or 13.7% of the population, living with HIV, one of the highest rates in the world. The country also has one of the world’s most impressive antiretroviral therapy programmes, with over 5 million people living with HIV currently on chronic treatment, leading to millions of people aging with chronic HIV infection.
However, while most HIV prevention and treatment programmes in South Africa remain focused on adolescents and young adults, a growing group of middle-aged and older adults with HIV, or at high risk, are being left behind. Research about sexual behavior, risk of HIV transmission, HIV stigma, and HIV prevention for adults over 40 years old has been limited until now.
The Health and Aging in Africa: Longitudinal Studies in South Africa study, known as Haalsa, seeks to better understand the risk of getting HIV and the health of aging adults with HIV in South Africa. This collaboration between the University of the Witwatersrand and Harvard University has followed a cohort of over 5,000 adults older than 40 in the Agincourt region in north-east South Africa for more than 10 years, gaining important insights about HIV in older populations.
The research uncovered a high prevalence of HIV among older adults, with 56% of respondents reporting sexual activity in the past 24 months. The study also found that the incidence rate of HIV for women was double that of men.
Moreover, HIV-related stigma poses a significant barrier to testing behavior among older adults, with a quarter of respondents reporting social stigma related to HIV infection. This stigma was found to have important implications for HIV care, as those experiencing high social stigma were less likely to engage in HIV testing and be linked to treatment.
The study also highlighted the critical importance of viral suppression for healthy aging, showing large gaps in life expectancy based on viral suppression status.
These insights are crucial to inform the design of interventions and policies to ensure healthy aging, tailored strategies to prevent new HIV infections, awareness programmes, and support to ensure that more people living with HIV in older age groups achieve and maintain viral suppression are urgently needed to reduce HIV risk in South African society and similar communities in sub-Saharan Africa.
