HIV infection in Eastern and Southern Africa: Highest burden, largest challenges, greatest potential

South Afr J HIV Med. 2021 May 28;22(1):1237. doi: 10.4102/sajhivmed.v22i1.1237. eCollection 2021.

Abstract

Background: The burden of HIV is especially concerning for Eastern and Southern Africa (ESA), as despite expansion of test-and-treat programmes, this region continues to experience significant challenges resulting from high rates of morbidity, mortality and new infections. Hard-won lessons from programmes on the ground in ESA should be shared.

Objectives: This report summarises relevant evidence and regional experts' recommendations regarding challenges specific to ESA.

Method: This commentary includes an in-depth review of relevant literature, progress against global goals and consensus opinion from experts.

Results: Recommendations include priorities for essential research (surveillance data collection, key and vulnerable population education and testing, in-country testing trials and evidence-based support services to improve retention in care) as well as research that can accelerate progress towards the prevention of new infections and achieving ambitious global goals in ESA.

Conclusion: The elimination of HIV in ESA will require continued investment, commitment to evidence-based programmes and persistence. Local research is critical to ensuring that responses in ESA are targeted, efficient and evaluated.

Keywords: HIV epidemiology; early diagnosis; prevention and control; public health; risk factors; vulnerable populations.