HIV and sexually transmitted co-infections among sex workers in the Southern African economic region

Background: The Southern African Development Community (SADC) economic block is the most affected region by HIV epidemic in Sub-Saharan Africa (SSA). Despite programmatic interventions, HIV infections remain unprecedentedly high among female sex workers (FSW) in the region. This review assesses the HIV burden and the drivers associated with FSW in the SADC region. Methods: We systematically extracted and analyzed HIV burden and other sexually transmitted infections (STIs) research data on FSW indexed in various journal platform and reports from governmental and nongovernmental organizations between 2003 and 2015. Meta-analysis technique was used to estimate the pooled prevalence of the HIV burden among FSW in the region. Results: Of the 192 peer-reviewed articles and reports addressing HIV burden, only 21 articles met eligibility criteria totaling 14998 FSW. The combined overall pool HIV prevalence was estimated at 42.0% (95% CI 0.41­0.43). The estimated pooled HIV prevalence ranged from 16% (95% CI 0.13­18) in Democratic Republic of Congo, 59% (95% CI 0.57­0.62) in South Africa and 71% (95% CI 0.65­0.76) in Malawi. The most common STIs reported were syphilis, Chlamydia, and gonorrhea with little emphasis on viruses. Structural factors such as stigma and discrimination, access to healthcare services and various socioeconomic and political barriers impeded treatment and prevention. Conclusion: The HIV prevalence among FSW was 5­30 times higher when compared to the overall female reproductive age population in the SADC region. This signifies and necessitates increase evidence based HIV/STIs research and programs among FSW in the SADC region

Fostering Prevention and Care Delivery Services Capability on HIV Pandemic and Ebola Outbreak Symbiosis in Africa

Human immunodeficiency virus (HIV) and the re-emerging Ebola virus disease (EVD) are closely intertwined and remain a persistent public health threat and global challenge. Their origin and rapid transmission and spread have similar boundaries and share overlapping impact characteristics; including related symptoms and other interactions. The controversies and global threat of these viruses require rapid response policy and evidence-based implementation findings. The constraints and dual burden inflicted by Ebola and HIV infections are highly characterized by similar socio-demographics; socio-economic and political factors. EVD has similar effects and burdens to HIV infection. This study seeks to understand EVD in the context of HIV epidemic despite the challenges in developing an effective vaccine against HIV and EVD. Our findings show that early understanding; prevention and treatment of these diseases a global health threat mainly in Africa is important and valuable. The lessons learned so far from HIV and Ebola epidemics are crucial in health programming and execution of rapid response interventions and continued vigilance against EVD before it become another worldwide health menace. Therefore; the current regional West Africa EVD requires strengthening healthcare systems and building preparedness and response capacity. Importantly; appropriate community participation; health education and resilience coupled with deployment of effective novel diagnostic approaches in early warning and surveillance of threats and emerging diseases. Therefore; there is an urgent need to develop novel key strategies are crucial in curbing the constant viral resurgence; persistence transmission dynamics and spread; as well in accelerating Ebola vaccines regimen (immunization) development and national implementation plans in achieving sustained control; and eventual elimination