Increasing the number of men who undergo circumcision and increasing the rates at which women with HIV are given antiretroviral therapy (ART) were associated with significant declines in the number of new male HIV infections in rural Ugandan communities, new Johns Hopkins Bloomberg School of Health research suggests.
The research, published July 12 in the Journal of the American Medical Association (JAMA), is believed to be the first to show that two promising prevention methods that were successful in tightly controlled clinical trial settings have real-world effects. The findings suggest that further scale-up of these programs throughout sub-Saharan Africa could slow the HIV epidemic in the region.
“The biology of these two prevention strategies has been proven, but the big question was whether these strategies could have an impact on the number of new HIV infections in communities still struggling to control the spread of the disease,” says study leader Xiangrong Kong, PhD, an associate scientist in the departments of Epidemiology and Biostatistics at the Bloomberg School. “Before our study, there was no empirical data to show the effects of scaling up these two interventions in real-world settings. It’s important to know whether prevention is working and this is evidence that strongly suggests that African nations should redouble their efforts to scale up these programs.”
The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates there are roughly 25.8 million people living with HIV in sub-Saharan Africa. In 2014, approximately 41 percent were on ART, though coverage rates vary widely. The World Health Organization estimates that between 2007 and 2015, more than 10 million men had been circumcised in 14 priority countries in this region. Given the findings of the new study, these circumcisions should have a dramatic impact on new HIV infections going forward.