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- An SA study found that those with STIs have a high risk of becoming HIV positive.
- Researchers recommend that integrated HIV and STI services and HIV prevention strategies be adopted.
- The study also found that under 40% of people living with long-term HIV were taking ART.
A new study has found that there are many new HIV infections and a large number of people whose viral loads are not suppressed in South Africa.
The study published in the South African Medical Journal evaluated HIV positivity, antiretroviral therapy (ART), viral suppression and new HIV infection among symptomatic patients with sexually transmitted infections (STIs) receiving medical care at two primary care clinics.
The study enrolled 451 men and women who presented with STI symptoms. The participants were interviewed, and genital and blood samples were collected for STI and HIV testing.
The researchers also examined the proportion of recently infected HIV-positive people who were taking ART and had a suppressed viral load. HIV-positive participants with detectable ARVs were considered to be on ART, while those with low viral loads were considered to be virally suppressed.
Increased HIV risk
The study found that most symptomatic STI service participants were HIV-negative but at risk of acquiring HIV, as they presented with signs of genital tract inflammation, and a significant number of participants had active and untreated STIs.
The study found that 20% of the participants were HIV positive and almost 16% of those who tested positive were new HIV infections. When compared with people with a negative HIV status, people with new HIV infections were independently linked with genital ulcers. The genital ulcers association was not seen in people with long-term HIV infection status.
“These findings strengthen the case for better integration of HIV prevention and care services with STI prevention, care and treatment. Integrated STI services should include HIV-related services such as counselling and testing, ART initiation, adherence support, VL [viral load] measurement and HIV drug resistance testing where indicated,” the study states.
The study also found that people who have been living with HIV for the long term had poor rates of taking ART, with only 38,5% on medication.
The researchers also recommend that pre-exposure prophylaxis (PrEP) services be integrated into STI services, and referral or provision of on-site voluntary medical male circumcision services also be expanded as part of the HIV prevention strategy.
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