#IAS2019: High HIV & STI rates in ECHO analyses

#IAS2019: High HIV & STI rates in ECHO analysesActivists say there is little urgency to provide adequate medical care to the transgender community in South Africa. (File photo)

New data from the study highlights the need for South Africa to step up HIV prevention for young women.

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MEXICO CITY – Almost 90% (345) of the women who contracted HIV during the ECHO trial were from South Africa. This is based on new research presented at the 10th IAS Conference on HIV Science (IAS 2019) in Mexico City.

The rate of HIV infection was higher at all of the South African sites than it was in the overall study, says Wits RHI Director for Network Trials Dr Thesla Palanee-Phillips. 

“[The rate of infection] at every South African site was greater than 3%. Now it’s staggering when you think of the number of people in [the] room — if there were one hundred of us, three would have HIV,” she explains.

About seven out of 100 women at the study site in Ladysmith, KwaZulu-Natal, contracted HIV during the course of the ECHO trial, the new research found.

Research shows that HIV is spreading at an escalated rate among girls and young women between the ages of 15 and 24 than in any other group in South Africa. According to the country’s latest HIV plan, about four out every 10 of these girls and women are newly infected with HIV — a rate that is four times higher than their male counterparts. 

In June, the much-anticipated results of the ECHO trial put uncertainty to rest when the study found that the use of one of the three different contraceptives — more specifically, Depo Provera — doesn’t increase a woman’s risk of contracting HIV. 

The study was conducted in eSwatini, South Africa, Zambia and Kenya and enrolled more than 7,800 women. Nine of the 12 sites were in South Africa.

Additionally, sexually transmitted infections (STIs) were also common at the start of the ECHO trial, with overall rates of 18.2% for chlamydia, 4.7% gonorrhoea and 38% infected with the herpes simplex virus. Another study, also presented at IAS 2019, found that women who were 24 years old and younger also had a higher rate of STI infection, which was also an indicator of HIV risk. 

Despite STI treatment during follow-up visits, about 4.8% and 15.4% of women were infected with gonorrhoea and chlamydia, respectively, at the end of the study. 

“Our take-home message here is that South African women — and other African women — are still at an extremely high risk of HIV infection. We need integration in PrEP delivery and prevention methods for men and women to see a collective reduction in risk,” Palanee-Phillips says. – Health-e News