Search

Background: Rapid antigen tests detecting SARS-CoV-2 are being increasingly used across the globe and were shown to be a useful tool in managing the COVID-19 pandemic. The purpose of this prospective study was to characterise the performance of four SARS-CoV-2 rapid antigen tests in a South African setting. Methods: Rapid antigen test evaluations were performed through drive-through testing centres in Durban, South Africa from July-December 2021. Two evaluation studies were performed: nasal Panbio COVID-19 Ag Rapid Test Device (Abbott) was evaluated in parallel with the nasopharyngeal Espline SARS-CoV-2 Ag test (Fujirebio, nasopharyngeal); followed by the evaluation of nasal RightSign COVID-19 Antigen Rapid test Cassette (Hangzhou Biotest Biotech) in parallel with the nasopharyngeal STANDARD Q COVID-19 Ag test (SD Biosensor). The Abbott RealTime SARS-CoV-2 assay was used as a reference test. Results: Evaluation of Panbio and Espline Ag tests was performed on 494 samples (31% positivity) while the evaluation of Standard Q and RightTest Ag tests was performed on 539 samples (13.17 % positivity). The overall sensitivity for all four tests ranged between 60-72% with excellent specificity values (>98%). Sensitivity increased to >80% in all tests in samples with Ct value Conclusions: All four evaluated tests detected a majority of the cases within the first week of symptom onset with high viral load and could be a valuable diagnostic tool for controlling the spread of SARS-CoV-2.

Achieving the UNAIDS 90-90-90 targets by 2020 is contingent on identifying and addressing mental health challenges that may affect HIV testing and treatment-related behaviors. This study is based on survey data from KwaZulu-Natal, South Africa (2014–2015). HIV positive women who reported higher depression scores had a lower odds of having tested previously for HIV (15–25 years: AOR = 0.90, 95% CI [0.83, 0.98]; 26–49 years: AOR = 0.90, 95% CI [0.84, 0.96]). Because HIV testing behavior represents a gateway to treatment, the findings suggest mental health may be one challenge to attaining the UNAIDS 90-90-90 targets.

BackgroundHIV incidence among adolescent girls and young women (AGYW) remains high, with their male partners a prominent factor in sustaining these elevated rates. Partnership characteristics remain important metrics for determining HIV risk, with evidence indicating that AGYW engaged in transactional and age-disparate relationships facing greater HIV exposure. This study examines the risk posed to AGYW in a relationship with a “Blesser” only, defined as male who provides his female partner with their material needs or desires in exchange for a sexual relationship and age-disparate (5 or more years older).MethodsA cross -sectional household based representative sample of AGYW (aged between 12–24 years) were enrolled in the study (n=18 926) from the districts of City of Johannesburg and Ekurhuleni in the Gauteng province and the Districts of eThekwini and uMgungundlovu in the province of KwaZulu-Natal (KZN) in South Africa between March 13, 2017 to June 22, 2018. Participants completed a structured questionnaire and provided finger-prick blood samples for laboratory measurements. Our analysis used descriptive statistics and multiple binary logistic regressions accounting for survey weights, clustering and stratification. FindingsWhilst all relationships exposed AGYW to potential HIV risk, multiple binary logistic regression analysis revealed that AGYW in a relationship with a Blesser and an age disparate partner were more likely to be HIV positive (AOR: 3.12, 95% CI: 1.76-5.53, p ConclusionDifferent relationships present different HIV to AGYW. AGYW who had engaged in relationships with both a Blesser and an age-disparate partner were at greater HIV risk when examined against these relationships independent of one another. The data reveals the compounded HIV risk of being in both a transactional and age-disparate relationship.

ObjectiveThis study investigated the behavioural, psychosocial and biological factors associated with HIV in a younger group of men (15 to 24 years) compared with an older group of men (25 to 35 years).DesignA household-based, cross-sectional study was conducted.SettingMen were randomly selected using a two-stage random sampling method in KwaZulu-Natal, South Africa, between June 2014 and June 2015.ParticipantsOverall, we interviewed 1472 younger men and 1138 older men. Only participants who could speak English or Zulu, were able to provide informed consent and who were expected to be living in the study area for the next 12 months were enrolled into the study.Primary and secondary outcomesHIV status was the primary outcome for the study. Men’s HIV status was derived from blood samples collected in the study which were tested for HIV antibodies.ResultsHIV prevalence was higher among older men (35.4%, 95% CI: 31.7 to 39.1) than younger men (7.6%, 95% CI: 6.2 to 9.4, pConclusionGiven that the HIV prevalence is higher in the older men, community based interventions need to target older men for medical circumcision and support HIV positive men to improve their material conditions early. For younger men intervening to reduce HIV risk behaviours at a young age before these behaviours become entrenched should be central to HIV prevention programmes.

BACKGROUND: The interaction of HIV risks in sexual networks remains unclear in South Africa. We provide an overview of the dynamics of HIV risks in South African men through a systematic scoping review. METHODS & ANALYSIS: Literature searches were conducted on seven online databases. Two reviewers independently screened articles against the inclusion criteria and performed a Kappa coefficient test to evaluate the degree of agreement on article selection. Thematic content analysis and a Mixed Method Appraisal Tool version 2018 were used to present the narrative account of the outcomes and to assess the risk of bias on included studies. RESULTS: Of the 1356 records identified, six studies reported on the dynamics of HIV infection in heterosexual men in sexual networks. All studies that were included were published between 2006 and 2016. The participants were aged 13 years and above and comprised of sero-discordant couples, HIV patients, and male and female in the general population. These studies were conducted in multiple diverse regions including South Africa, Senegal, Uganda, Malawi, Kenya, Tanzania, Botswana and Zambia. Evidence showed that age and sexual partnerships were most commonly identified attributes to either HIV infection and/or transmission risks in men. While other biological and behavioral data were reported, the results were not specific to men. DISCUSSION: The impact of age and sexual partnerships are poorly understood and the data available limit inferences to South African men. Limited empiric evidence of HIV risk among men impacts on the design, development and tailoring of HIV prevention interventions to alter the trajectory.

ObjectiveThis study examines the role of age-disparate partnerships on young women’s HIV risk by investigating coital frequency and condom use within age-disparate partnerships involving women aged 15 to 24.DesignA community-based, cross-sectional study was conducted.SettingParticipants were randomly selected using a two-stage random sampling method in uMgungundlovu district, KwaZulu-Natal, South Africa, between June 2014 and June 2015.ParticipantsA total of 1306 15–24-year-old women in an ongoing heterosexual partnership were included in the analysis. Participants had to be a resident in the area for 12 months, and able to provide informed consent and speak one of the local languages (Zulu or English).Primary and secondary outcome measuresSexual frequency was assessed by asking participants how many times they had sex with each partner in the past 12 months. The degree of condomless sex within partnerships was assessed in the survey by asking participants how often they used a condom with their partners.ResultsAge-disparate partnerships were associated with a higher order category (once, 2–5, 6–10, 11–20, >20) of coital frequency (adjusted OR (aOR) 1.32, pConclusionThe finding that increased sexual activity is positively associated with age-disparate partnerships adds to the evidence that age-disparate partnerships pose greater HIV risk for young women. Our study results indicate that interventions to reduce risky sexual behaviour within age-disparate partnerships remain relevant to reducing the high HIV incidence rates among adolescent girls and young women.