msf kwazulu-natal, south africa: bending the curves of hiv ... · operational research day,...

OPERATIONAL RESEARCH DAY, Brussels – 31 May 2019

MSF KwaZulu-Natal, South Africa: Bending the Curves of HIV & TB

2011-2018

Nolwenn Conan, Erica Simons, Liesbet Ohler, Ellie FordKamara, Maphalala Thembelihle, Linda Dlamini, Amir Shroufi, Gilles van Cutsem, Laura Trivino-

Duran , Menard L. Chihana, Helena Huerga,


KZN Project: “Bending the curves” since

2011;

Aim to reduce HIV/TB incidence and

morbidity/mortality;

Impact Surveys in 2013 and 2018

Tshwane

Cape Town

Mbongolwane

Eshowe

Bending the curves

VL

Retain

Adhere

Treat

Link

Test

Prevent

HEA

LTH

PRO

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N, M

&E,

ADV

OCA

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COM

MU

NIT

Y M

OBI

LISA

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N, M

ENTO

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G, L

AB

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ORT

, LO

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ORT



Prevention efforts

• Condom Distribution at Facilities and communities (Coloured Flavoured Condoms)

• MMC support • Schools: SRH Education • CHAPs/Health Promotion


1st 90: Ensuring that 90% of people with HIV know their status


• Initiation counseling; • Introduction of nurses

trained in integrated management of ARTs

2nd 90: Ensuring that 90% of people with HIV are on treatment


3rd 90: Ensuring that 90% of people with HIV on treatment have viral suppression

• Mentoring of National Adherence Guidelines

• Community-based differentiated models of care


Results of 2nd Population based survey

1st 90 2nd 90 3rd 90*

2013 76% 70% 93%

+14% +25% +1%

2018 90% 95% 94%

1st 90 2nd 90 3rd 90*

2018 85% 71% 88%

Comparison with national statistics (SABSSM V)


Women Men

Chart1

Aware HIV+ statusAware HIV+ statusAware HIV+ status

On ARTOn ARTOn ART

Viral Load < 1,000 copies/mlViral Load < 1,000 copies/mlViral Load < 1,000 copies/ml

15-29

30-44

45- 59

%

0.861

0.928

0.962

0.789

0.8815

0.962

0.757

0.882

0.962

909090

Cascade of care (%)15-59 years

20132018

AllWomenMenAllWomenMen

HIV +100%100%100%100%100%100%

Aware of HIV Status76.4%74.1- 78.679.0%76.4- 81.468.3%63.1- 73.1%89.7%87.5- 91.591.9%89.6- 93.882.5%76.7- 87.1

Linked to care71.0%68.6- 73.473.4%71.6- 76.960.4%54.2- 66.1%88.5%86.1- 90.491.1%88.7- 93.179.9%73.8- 84.9

In Care62.7%59.8- 65.666.5%63.5- 69.350.6%44.6- 56.6%84.5%81.9- 86.788.3%85.6- 90.672.1%65.5- 77.8

On ART (test and treat)53.5%50.6- 56.355.7%52.8- 58.546.3%40.5- 52.3%84.1%81.5- 86.487.9%85.1- 90.272.1%65.5- 77.8

Viral Load < 1,000 copies/ml57.4%54.6- 60.160.3%57.4- 63.147.9%41.7- 54.1%83.9%81.3- 86.387.2%84.3- 89.673.3%66.7- 79.1

20132018

HIV +100%100%

Aware of HIV Status76.4%89.7%

Linked to care71.0%88.5%

In Care62.7%84.5%

On ART (test and treat)53.5%84.1%

Viral Load < 1,000 copies/ml57.4%83.9%

OverallWomenMen

909090909090909090

%95%CI%95%CI%95%CI%95%CI%95%CI%95%CI%95%CI%95%CI%95%CI

201376.474.1- 78.669.967.0- 72.793.191.0- 94.879.076.4- 81.470.567.7- 73.293.491.1- 95.168.363.1- 73.1%67.960.8- 74.292.186.0- 95.7

201889.787.5- 91.593.593.5- 96.994.492.4- 95.991.989.6- 93.895.593.5- 96.995.092.8- 96.582.576.7- 87.186.480.3- 90.892.386.5- 95.7

2013 results1st 9076.4% (95% CI: 74.1–78.6)

2nd 9069.9% (95% CI: 67.0–72.7)

3rd 9093.1% (95% CI: 91.0–94.8)

909090

2013

2018

Sheet3

Aware HIV+ statusWomenMenlinked to careWomenMenIn careWomenMenOn ARTWomenMenViral Load < 1,000 copies/mlWomenMen

15-1985.2%66.5- 94.369.2%40.7- 88.115-1982.1%63.6- 92.469.2%40.7- 88.115-1982.1%63.6- 92.469.3%40.7- 88.115-1982.1%63.6- 92.469.2%40.7- 88.115-1973.1%53.2- 86.658.3%30.6- 81.7

20-2483.3%72.3- 90.560.0%19.8- 90.120-2481.5%70.2- 89.275.0%23.5- 96.720-2475.4%63.5- 84.475.0%23.5- 96.720-2473.9%61.9- 83.175.0%23.5- 96.720-2473.3%60.8- 83.066.7%15.1- 95.7

25-2988.5%79.9- 93.755.6%32.9- 76.125-2987.4%78.6- 92.955.6%32.9- 76.125-2982.8%73.3- 89.327.8%12.0- 52.125-2981.6%72.0- 88.427.8%11.9- 52.125-2978.3%68.2- 85.946.7%23.9- 70 9

30-3488.6%81.3-93.383.3%67.4- 92.430-3488.5%81.2- 93.283.3%67.4- 92.430-3485.8%78.1- 91.275.0%58.4- 86.530-3485.8%78.1- 91.275.0%58.4- 86.530-3484.1%75.9- 89.971.4%54.4- 84.0

35-3995.7%89.1- 98.485.4%70.9- 93.335-3992.5%85.0- 96.480.0%64.7- 89.735-3991.3%83.5- 95.675.0%59.3- 86.135-3991.3%83.5- 95.675.0%59.3- 86.135-3989.1%81.0- 94.177.5%62.0- 87.9

40-4495.2%87.8- 98.284.6%65.3- 94.240-4495.5%87.8- 98.280.8%61.1- 91.840-4489.0%80.2- 94.273.1%53.1- 86.740-4487.8%78.8- 93.373.1%53.1- 86.740-4492.5%84.3- 96.675.0%54.2- 88.4

45-4994.1%85.3- 97.892.3%73.7- 98.145-4994.1%85.3- 87.884.6%65.3- 94.245-4994.1%85.3- 97.876.9%57.1- 89.345-4994.1%85.3- 97.876.9%57.1- 89.345-4995.5%87.0- 98.676.0%55.7- 88.9

50-5498.6%90.4- 99.886.4%65.0- 95.650-5498.6%90.4- 99.886.4%65.0- 95.650-5497.1%89.1- 99.381.8%60.2- 93.150-5497.1%89.1- 99.381.8%60.2- 93.150-5497.1%89.1- 99.381.8%60.2- 94.2

55-5995.9%85.1- 99.094.7%70.3- 99.355-5997.9%86.6- 99.789.5%66.0- 97.455-5997.9%86.6- 99.784.2%60.6- 94.955-5997.9%86.6- 99.784.2%60.6- 94.955-5995.8%84.8- 99.084.4%60.6- 94.9

60-6496.2%77.1- 99.5100.0%60-6492.3%73.9- 98.1100.0%60-6492.3%73.9- 98.1100.0%60-6492.3%73.9- 98.1100.0%60-64100.0%100.0%

65-6988.5%69.7- 96.281.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.5

70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%

75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%


15-1985.2%69.2%15-1982.1%69.2%15-1982.1%69.3%15-1982.1%69.2%15-1973.1%58.3%

20-2483.3%60.0%20-2481.5%75.0%20-2475.4%75.0%20-2473.9%75.0%20-2473.3%66.7%

25-2988.5%55.6%25-2987.4%55.6%25-2982.8%27.8%25-2981.6%27.8%25-2978.3%46.7%

30-3488.6%83.3%30-3488.5%83.3%30-3485.8%75.0%30-3485.8%75.0%30-3484.1%71.4%

35-3995.7%85.4%35-3992.5%80.0%35-3991.3%75.0%35-3991.3%75.0%35-3989.1%77.5%

40-4495.2%84.6%40-4495.5%80.8%40-4489.0%73.1%40-4487.8%73.1%40-4492.5%75.0%

45-4994.1%92.3%45-4994.1%84.6%45-4994.1%76.9%45-4994.1%76.9%45-4995.5%76.0%

50-5498.6%86.4%50-5498.6%86.4%50-5497.1%81.8%50-5497.1%81.8%50-5497.1%81.8%

55-5995.9%94.7%55-5997.9%89.5%55-5997.9%84.2%55-5997.9%84.2%55-5995.8%84.4%

60-6496.2%100.0%60-6492.3%100.0%60-6492.3%100.0%60-6492.3%100.0%60-64100.0%100.0%

65-6988.5%81.8%65-6992.3%81.8%65-6992.3%81.8%65-6992.3%81.8%65-6992.3%81.8%

70-7466.7%100.0%70-7466.7%100.0%70-7466.7%100.0%70-7466.7%100.0%70-7466.7%100.0%

75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%

Women

Aware HIV+ statuslinked to careIn careOn ARTViral Load < 1,000 copies/ml15-1920-2425-2930-3435-3940-4445-4950-5455-59

15-19100%85.2%82.1%82.1%82.1%73.1%Aware HIV+ status85.2%83.3%88.5%88.6%95.7%95.2%94.1%98.6%95.9%

20-24100%83.3%81.5%75.4%73.9%73.3%linked to care82.1%81.5%87.4%88.5%92.5%95.5%94.1%98.6%97.9%

25-29100%88.5%87.4%82.8%81.6%78.3%In care82.1%75.4%82.8%85.8%91.3%89.0%94.1%97.1%97.9%

30-34100%88.6%88.5%85.8%85.8%84.1%On ART82.1%73.9%81.6%85.8%91.3%87.8%94.1%97.1%97.9%

35-39100%95.7%92.5%91.3%91.3%89.1%Viral Load < 1,000 copies/ml73.1%73.3%78.3%84.1%89.1%92.5%95.5%97.1%95.8%

40-44100%95.2%95.5%89.0%87.8%92.5%

45-49100%94.1%94.1%94.1%94.1%95.5%Men

50-54100%98.6%98.6%97.1%97.1%97.1%15-1920-2425-2930-3435-3940-4445-4950-5455-59

55-59100%95.9%97.9%97.9%97.9%95.8%Aware HIV+ status69.2%60.0%55.6%83.3%85.4%84.6%92.3%86.4%94.7%

60-64100%96.2%92.3%92.3%92.3%100.0%linked to care69.2%75.0%55.6%83.3%80.0%80.8%84.6%86.4%89.5%

65-69100%88.5%92.3%92.3%92.3%92.3%In care69.3%75.0%27.8%75.0%75.0%73.1%76.9%81.8%84.2%

70-74100%66.7%66.7%66.7%66.7%66.7%On ART69.2%75.0%27.8%75.0%75.0%73.1%76.9%81.8%84.2%

75+100%100.0%100.0%100.0%100.0%100.0%Viral Load < 1,000 copies/ml58.3%66.7%46.7%71.4%77.5%75.0%76.0%81.8%84.4%

Sheet3

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

Women

Sheet3 (2)

Aware HIV+ status

linked to care

In care

On ART

Viral Load < 1,000 copies/ml

Men

Sheet3 (3)

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

Men

prevalence

Aware HIV+ status

linked to care

In care

On ART


Women

909090


15-1985.2%66.5- 94.369.2%40.7- 88.115-1982.1%63.6- 92.469.2%40.7- 88.115-1982.1%63.6- 92.469.3%40.7- 88.115-1982.1%63.6- 92.469.2%40.7- 88.115-1973.1%53.2- 86.658.3%30.6- 81.7

20-2483.3%72.3- 90.560.0%19.8- 90.120-2481.5%70.2- 89.275.0%23.5- 96.720-2475.4%63.5- 84.475.0%23.5- 96.720-2473.9%61.9- 83.175.0%23.5- 96.720-2473.3%60.8- 83.066.7%15.1- 95.7

25-2988.5%79.9- 93.755.6%32.9- 76.125-2987.4%78.6- 92.955.6%32.9- 76.125-2982.8%73.3- 89.327.8%12.0- 52.125-2981.6%72.0- 88.427.8%11.9- 52.125-2978.3%68.2- 85.946.7%23.9- 70 9

30-3488.6%81.3-93.383.3%67.4- 92.430-3488.5%81.2- 93.283.3%67.4- 92.430-3485.8%78.1- 91.275.0%58.4- 86.530-3485.8%78.1- 91.275.0%58.4- 86.530-3484.1%75.9- 89.971.4%54.4- 84.0

35-3995.7%89.1- 98.485.4%70.9- 93.335-3992.5%85.0- 96.480.0%64.7- 89.735-3991.3%83.5- 95.675.0%59.3- 86.135-3991.3%83.5- 95.675.0%59.3- 86.135-3989.1%81.0- 94.177.5%62.0- 87.9

40-4495.2%87.8- 98.284.6%65.3- 94.240-4495.5%87.8- 98.280.8%61.1- 91.840-4489.0%80.2- 94.273.1%53.1- 86.740-4487.8%78.8- 93.373.1%53.1- 86.740-4492.5%84.3- 96.675.0%54.2- 88.4

45-4994.1%85.3- 97.892.3%73.7- 98.145-4994.1%85.3- 87.884.6%65.3- 94.245-4994.1%85.3- 97.876.9%57.1- 89.345-4994.1%85.3- 97.876.9%57.1- 89.345-4995.5%87.0- 98.676.0%55.7- 88.9

50-5498.6%90.4- 99.886.4%65.0- 95.650-5498.6%90.4- 99.886.4%65.0- 95.650-5497.1%89.1- 99.381.8%60.2- 93.150-5497.1%89.1- 99.381.8%60.2- 93.150-5497.1%89.1- 99.381.8%60.2- 94.2

55-5995.9%85.1- 99.094.7%70.3- 99.355-5997.9%86.6- 99.789.5%66.0- 97.455-5997.9%86.6- 99.784.2%60.6- 94.955-5997.9%86.6- 99.784.2%60.6- 94.955-5995.8%84.8- 99.084.4%60.6- 94.9

60-6496.2%77.1- 99.5100.0%60-6492.3%73.9- 98.1100.0%60-6492.3%73.9- 98.1100.0%60-6492.3%73.9- 98.1100.0%60-64100.0%100.0%

65-6988.5%69.7- 96.281.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.5

70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%

75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%


15-1985.2%69.2%15-1982.1%69.2%15-1982.1%69.3%15-1982.1%69.2%15-1973.1%58.3%

20-2483.3%60.0%20-2481.5%75.0%20-2475.4%75.0%20-2473.9%75.0%20-2473.3%66.7%

25-2988.5%55.6%25-2987.4%55.6%25-2982.8%27.8%25-2981.6%27.8%25-2978.3%46.7%

30-3488.6%83.3%30-3488.5%83.3%30-3485.8%75.0%30-3485.8%75.0%30-3484.1%71.4%

35-3995.7%85.4%35-3992.5%80.0%35-3991.3%75.0%35-3991.3%75.0%35-3989.1%77.5%

40-4495.2%84.6%40-4495.5%80.8%40-4489.0%73.1%40-4487.8%73.1%40-4492.5%75.0%

45-4994.1%92.3%45-4994.1%84.6%45-4994.1%76.9%45-4994.1%76.9%45-4995.5%76.0%

50-5498.6%86.4%50-5498.6%86.4%50-5497.1%81.8%50-5497.1%81.8%50-5497.1%81.8%

55-5995.9%94.7%55-5997.9%89.5%55-5997.9%84.2%55-5997.9%84.2%55-5995.8%84.4%

60-6496.2%100.0%60-6492.3%100.0%60-6492.3%100.0%60-6492.3%100.0%60-64100.0%100.0%

65-6988.5%81.8%65-6992.3%81.8%65-6992.3%81.8%65-6992.3%81.8%65-6992.3%81.8%

70-7466.7%100.0%70-7466.7%100.0%70-7466.7%100.0%70-7466.7%100.0%70-7466.7%100.0%

75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%

Women


15-19100%85.2%82.1%82.1%82.1%73.1%Aware HIV+ status85.2%83.3%88.5%88.6%95.7%95.2%94.1%98.6%95.9%

30-34100%88.6%88.5%85.8%85.8%84.1%On ART82.1%73.9%81.6%85.8%91.3%87.8%94.1%97.1%97.9%


40-44100%95.2%95.5%89.0%87.8%92.5%

45-49100%94.1%94.1%94.1%94.1%95.5%Men

50-54100%98.6%98.6%97.1%97.1%97.1%15-1920-2425-2930-3435-3940-4445-4950-5455-59

55-59100%95.9%97.9%97.9%97.9%95.8%Aware HIV+ status69.2%60.0%55.6%83.3%85.4%84.6%92.3%86.4%94.7%

70-74100%66.7%66.7%66.7%66.7%66.7%On ART69.2%75.0%27.8%75.0%75.0%73.1%76.9%81.8%84.2%


909090

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

Women

HIV testing

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

Men

HIV testing (2)

Women

15-2930-4445- 59

Aware HIV+ status86.1%92.8%96.2%

On ART78.9%88.2%96.2%

Viral Load < 1,000 copies/ml75.7%88.2%96.2%

Men

15-2930-4445-59


On ART48.6%74.5%80.6%


HIV testing (2)

000000

15-29

30-44

45- 59

Women

TBNumber of people

000000

15-29

30-44

45-59

Men

15-29

30-44

45- 59

%

15-29

30-44

45-59

Prevalence stratified by gender

Men20182013

20132018%95%CI%95%CI

15-191.80.4Overall26.424.9- 27.925.223.6- 26.9

20-244.42.6Women30.528.6- 32.530.929.0-32.9

25-2919.314.5Men18.416.3- 20.815.914.0- 18.0

30-3435.637.5

35-3945.543.6

40-4437.632.5

45-4936.638.8

50-5430.733.3

55-5916.732.2

Women

20132018

15-197.57.3

20-2425.919.2

25-2940.937.3

30-3456.544.4

35-3955.550.5

40-4449.448.8

45-4933.241.5

50-5426.634.3

55-5919.822.2

Overall

20132018

15-195.7

20-2413.3

25-2929.4

30-3442.5

35-3948.2

40-4443.6

45-4940.7

50-5434.1

55-5916.724.3

Author:infection a al naissance

Women 2013

Women 2018

Age Group

%

Men 2013

Men 2018

Age Group

%

OverallWomenMen

909090909090909090

201376.469.993.179.070.593.468.367.992.1

201890.894.895.292.296.196.485.890.290.8

Overall20132018

%95%CI

1st 9076.474.1–78.690.887.9- 93.0

2nd 9069.967.0–72.794.892.4- 96.5

3rd 9093.191.0–94.895.292.7- 96.9

Women20132018

%95%CI

1st 9079.076.4- 81.492.289.2- 94.5

2nd 9070.567.7- 73.296.193.6- 97.7

3rd 9093.491.1- 95.196.493.7- 97.9

Men20132018

%95%CI

1st 9068.363.1- 73.185.878.4- 91.0

2nd 9067.960.8- 74.290.282.7- 94.7

3rd 9092.186.0- 95.790.882.6- 95.4

Overall 15-59

OverallWomenMen

n%95%CIn%95%CIn%95%CI

20134,59881.479.8- 82.93,11088.486.8- 89.91,48869.867.2- 72.4

20183,28696.796.1- 97.32,16498.197.4- 98.6112294.292.7- 95.4

Age groupMenWomen

15-1993.0%94.5%

20-2496.8%99.4%

25-2996.8%99.6%

30-3494.8%99.6%

35-3995.7%99.5%

40-4491.4%99.4%

45-4994.0%99.4%

50-5489.4%97.5%

55-5993.2%96.0%

Men

Women

Age Group

%

Among negative 15-59

OverallWomenMen


2013

20182,4099695.1- 96.71,49797.396.4- 98.091293.892.0- 95.2

Age groupMenWomen

15-1993.9%94.1%

20-2496.8%99.3%

25-2997.2%100.0%

30-3491.7%99.3%

35-3994.3%98.9%

40-4488.9%98.9%

45-4990.2%100.0%

50-5484.1%96.2%

55-5992.5%94.8%

Men

Women

Age Group

%

Number of people scereened with WHO questions

Number of particpants who answer at least once positively to one of the questions

Number of particpants who produce a sputum

Number of particpants with a TB resultSensitive to Izoniazid, Rifampicin, Ethambutol, Streptomycin

Number of participants who were told thay had TB

Number of participant with a current treatment

Number of participant with a previous treatment

Chart1

Aware HIV+ statusAware HIV+ statusAware HIV+ status

On ARTOn ARTOn ART

Viral Load < 1,000 copies/mlViral Load < 1,000 copies/mlViral Load < 1,000 copies/ml

15-29

30-44

45-59

%

0.616

0.845

0.91

0.486

0.745

0.806

0.533

0.748

0.803

909090

Cascade of care (%)15-59 years

20132018

AllWomenMenAllWomenMen

HIV +100%100%100%100%100%100%

Aware of HIV Status76.4%74.1- 78.679.0%76.4- 81.468.3%63.1- 73.1%89.7%87.5- 91.591.9%89.6- 93.882.5%76.7- 87.1

Linked to care71.0%68.6- 73.473.4%71.6- 76.960.4%54.2- 66.1%88.5%86.1- 90.491.1%88.7- 93.179.9%73.8- 84.9

In Care62.7%59.8- 65.666.5%63.5- 69.350.6%44.6- 56.6%84.5%81.9- 86.788.3%85.6- 90.672.1%65.5- 77.8

On ART (test and treat)53.5%50.6- 56.355.7%52.8- 58.546.3%40.5- 52.3%84.1%81.5- 86.487.9%85.1- 90.272.1%65.5- 77.8

Viral Load < 1,000 copies/ml57.4%54.6- 60.160.3%57.4- 63.147.9%41.7- 54.1%83.9%81.3- 86.387.2%84.3- 89.673.3%66.7- 79.1

20132018

HIV +100%100%

Aware of HIV Status76.4%89.7%

Linked to care71.0%88.5%

In Care62.7%84.5%

On ART (test and treat)53.5%84.1%

Viral Load < 1,000 copies/ml57.4%83.9%

OverallWomenMen

909090909090909090

%95%CI%95%CI%95%CI%95%CI%95%CI%95%CI%95%CI%95%CI%95%CI

201376.474.1- 78.669.967.0- 72.793.191.0- 94.879.076.4- 81.470.567.7- 73.293.491.1- 95.168.363.1- 73.1%67.960.8- 74.292.186.0- 95.7

201889.787.5- 91.593.593.5- 96.994.492.4- 95.991.989.6- 93.895.593.5- 96.995.092.8- 96.582.576.7- 87.186.480.3- 90.892.386.5- 95.7

2013 results1st 9076.4% (95% CI: 74.1–78.6)

2nd 9069.9% (95% CI: 67.0–72.7)

3rd 9093.1% (95% CI: 91.0–94.8)

909090

2013

2018

Sheet3


15-1985.2%66.5- 94.369.2%40.7- 88.115-1982.1%63.6- 92.469.2%40.7- 88.115-1982.1%63.6- 92.469.3%40.7- 88.115-1982.1%63.6- 92.469.2%40.7- 88.115-1973.1%53.2- 86.658.3%30.6- 81.7

20-2483.3%72.3- 90.560.0%19.8- 90.120-2481.5%70.2- 89.275.0%23.5- 96.720-2475.4%63.5- 84.475.0%23.5- 96.720-2473.9%61.9- 83.175.0%23.5- 96.720-2473.3%60.8- 83.066.7%15.1- 95.7

25-2988.5%79.9- 93.755.6%32.9- 76.125-2987.4%78.6- 92.955.6%32.9- 76.125-2982.8%73.3- 89.327.8%12.0- 52.125-2981.6%72.0- 88.427.8%11.9- 52.125-2978.3%68.2- 85.946.7%23.9- 70 9

30-3488.6%81.3-93.383.3%67.4- 92.430-3488.5%81.2- 93.283.3%67.4- 92.430-3485.8%78.1- 91.275.0%58.4- 86.530-3485.8%78.1- 91.275.0%58.4- 86.530-3484.1%75.9- 89.971.4%54.4- 84.0

35-3995.7%89.1- 98.485.4%70.9- 93.335-3992.5%85.0- 96.480.0%64.7- 89.735-3991.3%83.5- 95.675.0%59.3- 86.135-3991.3%83.5- 95.675.0%59.3- 86.135-3989.1%81.0- 94.177.5%62.0- 87.9

40-4495.2%87.8- 98.284.6%65.3- 94.240-4495.5%87.8- 98.280.8%61.1- 91.840-4489.0%80.2- 94.273.1%53.1- 86.740-4487.8%78.8- 93.373.1%53.1- 86.740-4492.5%84.3- 96.675.0%54.2- 88.4

45-4994.1%85.3- 97.892.3%73.7- 98.145-4994.1%85.3- 87.884.6%65.3- 94.245-4994.1%85.3- 97.876.9%57.1- 89.345-4994.1%85.3- 97.876.9%57.1- 89.345-4995.5%87.0- 98.676.0%55.7- 88.9

50-5498.6%90.4- 99.886.4%65.0- 95.650-5498.6%90.4- 99.886.4%65.0- 95.650-5497.1%89.1- 99.381.8%60.2- 93.150-5497.1%89.1- 99.381.8%60.2- 93.150-5497.1%89.1- 99.381.8%60.2- 94.2

55-5995.9%85.1- 99.094.7%70.3- 99.355-5997.9%86.6- 99.789.5%66.0- 97.455-5997.9%86.6- 99.784.2%60.6- 94.955-5997.9%86.6- 99.784.2%60.6- 94.955-5995.8%84.8- 99.084.4%60.6- 94.9

60-6496.2%77.1- 99.5100.0%60-6492.3%73.9- 98.1100.0%60-6492.3%73.9- 98.1100.0%60-6492.3%73.9- 98.1100.0%60-64100.0%100.0%

65-6988.5%69.7- 96.281.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.5

70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%

75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%


15-1985.2%69.2%15-1982.1%69.2%15-1982.1%69.3%15-1982.1%69.2%15-1973.1%58.3%

20-2483.3%60.0%20-2481.5%75.0%20-2475.4%75.0%20-2473.9%75.0%20-2473.3%66.7%

25-2988.5%55.6%25-2987.4%55.6%25-2982.8%27.8%25-2981.6%27.8%25-2978.3%46.7%

30-3488.6%83.3%30-3488.5%83.3%30-3485.8%75.0%30-3485.8%75.0%30-3484.1%71.4%

35-3995.7%85.4%35-3992.5%80.0%35-3991.3%75.0%35-3991.3%75.0%35-3989.1%77.5%

40-4495.2%84.6%40-4495.5%80.8%40-4489.0%73.1%40-4487.8%73.1%40-4492.5%75.0%

45-4994.1%92.3%45-4994.1%84.6%45-4994.1%76.9%45-4994.1%76.9%45-4995.5%76.0%

50-5498.6%86.4%50-5498.6%86.4%50-5497.1%81.8%50-5497.1%81.8%50-5497.1%81.8%

55-5995.9%94.7%55-5997.9%89.5%55-5997.9%84.2%55-5997.9%84.2%55-5995.8%84.4%

60-6496.2%100.0%60-6492.3%100.0%60-6492.3%100.0%60-6492.3%100.0%60-64100.0%100.0%

65-6988.5%81.8%65-6992.3%81.8%65-6992.3%81.8%65-6992.3%81.8%65-6992.3%81.8%

70-7466.7%100.0%70-7466.7%100.0%70-7466.7%100.0%70-7466.7%100.0%70-7466.7%100.0%

75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%

Women


15-19100%85.2%82.1%82.1%82.1%73.1%Aware HIV+ status85.2%83.3%88.5%88.6%95.7%95.2%94.1%98.6%95.9%

20-24100%83.3%81.5%75.4%73.9%73.3%linked to care82.1%81.5%87.4%88.5%92.5%95.5%94.1%98.6%97.9%

25-29100%88.5%87.4%82.8%81.6%78.3%In care82.1%75.4%82.8%85.8%91.3%89.0%94.1%97.1%97.9%

30-34100%88.6%88.5%85.8%85.8%84.1%On ART82.1%73.9%81.6%85.8%91.3%87.8%94.1%97.1%97.9%


40-44100%95.2%95.5%89.0%87.8%92.5%

45-49100%94.1%94.1%94.1%94.1%95.5%Men

50-54100%98.6%98.6%97.1%97.1%97.1%15-1920-2425-2930-3435-3940-4445-4950-5455-59

55-59100%95.9%97.9%97.9%97.9%95.8%Aware HIV+ status69.2%60.0%55.6%83.3%85.4%84.6%92.3%86.4%94.7%

60-64100%96.2%92.3%92.3%92.3%100.0%linked to care69.2%75.0%55.6%83.3%80.0%80.8%84.6%86.4%89.5%

65-69100%88.5%92.3%92.3%92.3%92.3%In care69.3%75.0%27.8%75.0%75.0%73.1%76.9%81.8%84.2%

70-74100%66.7%66.7%66.7%66.7%66.7%On ART69.2%75.0%27.8%75.0%75.0%73.1%76.9%81.8%84.2%


Sheet3

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

Women

Sheet3 (2)

Aware HIV+ status

linked to care

In care

On ART


Men

Sheet3 (3)

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

Men

prevalence

Aware HIV+ status

linked to care

In care

On ART


Women

909090


15-1985.2%66.5- 94.369.2%40.7- 88.115-1982.1%63.6- 92.469.2%40.7- 88.115-1982.1%63.6- 92.469.3%40.7- 88.115-1982.1%63.6- 92.469.2%40.7- 88.115-1973.1%53.2- 86.658.3%30.6- 81.7

20-2483.3%72.3- 90.560.0%19.8- 90.120-2481.5%70.2- 89.275.0%23.5- 96.720-2475.4%63.5- 84.475.0%23.5- 96.720-2473.9%61.9- 83.175.0%23.5- 96.720-2473.3%60.8- 83.066.7%15.1- 95.7

25-2988.5%79.9- 93.755.6%32.9- 76.125-2987.4%78.6- 92.955.6%32.9- 76.125-2982.8%73.3- 89.327.8%12.0- 52.125-2981.6%72.0- 88.427.8%11.9- 52.125-2978.3%68.2- 85.946.7%23.9- 70 9

30-3488.6%81.3-93.383.3%67.4- 92.430-3488.5%81.2- 93.283.3%67.4- 92.430-3485.8%78.1- 91.275.0%58.4- 86.530-3485.8%78.1- 91.275.0%58.4- 86.530-3484.1%75.9- 89.971.4%54.4- 84.0

35-3995.7%89.1- 98.485.4%70.9- 93.335-3992.5%85.0- 96.480.0%64.7- 89.735-3991.3%83.5- 95.675.0%59.3- 86.135-3991.3%83.5- 95.675.0%59.3- 86.135-3989.1%81.0- 94.177.5%62.0- 87.9

40-4495.2%87.8- 98.284.6%65.3- 94.240-4495.5%87.8- 98.280.8%61.1- 91.840-4489.0%80.2- 94.273.1%53.1- 86.740-4487.8%78.8- 93.373.1%53.1- 86.740-4492.5%84.3- 96.675.0%54.2- 88.4

45-4994.1%85.3- 97.892.3%73.7- 98.145-4994.1%85.3- 87.884.6%65.3- 94.245-4994.1%85.3- 97.876.9%57.1- 89.345-4994.1%85.3- 97.876.9%57.1- 89.345-4995.5%87.0- 98.676.0%55.7- 88.9

50-5498.6%90.4- 99.886.4%65.0- 95.650-5498.6%90.4- 99.886.4%65.0- 95.650-5497.1%89.1- 99.381.8%60.2- 93.150-5497.1%89.1- 99.381.8%60.2- 93.150-5497.1%89.1- 99.381.8%60.2- 94.2

55-5995.9%85.1- 99.094.7%70.3- 99.355-5997.9%86.6- 99.789.5%66.0- 97.455-5997.9%86.6- 99.784.2%60.6- 94.955-5997.9%86.6- 99.784.2%60.6- 94.955-5995.8%84.8- 99.084.4%60.6- 94.9

60-6496.2%77.1- 99.5100.0%60-6492.3%73.9- 98.1100.0%60-6492.3%73.9- 98.1100.0%60-6492.3%73.9- 98.1100.0%60-64100.0%100.0%

65-6988.5%69.7- 96.281.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.565-6992.3%73.9- 98.181.8%49.0- 95.5

70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%70-7466.7%15.3- 95.7100.0%

75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%


15-1985.2%69.2%15-1982.1%69.2%15-1982.1%69.3%15-1982.1%69.2%15-1973.1%58.3%

20-2483.3%60.0%20-2481.5%75.0%20-2475.4%75.0%20-2473.9%75.0%20-2473.3%66.7%

25-2988.5%55.6%25-2987.4%55.6%25-2982.8%27.8%25-2981.6%27.8%25-2978.3%46.7%

30-3488.6%83.3%30-3488.5%83.3%30-3485.8%75.0%30-3485.8%75.0%30-3484.1%71.4%

35-3995.7%85.4%35-3992.5%80.0%35-3991.3%75.0%35-3991.3%75.0%35-3989.1%77.5%

40-4495.2%84.6%40-4495.5%80.8%40-4489.0%73.1%40-4487.8%73.1%40-4492.5%75.0%

45-4994.1%92.3%45-4994.1%84.6%45-4994.1%76.9%45-4994.1%76.9%45-4995.5%76.0%

50-5498.6%86.4%50-5498.6%86.4%50-5497.1%81.8%50-5497.1%81.8%50-5497.1%81.8%

55-5995.9%94.7%55-5997.9%89.5%55-5997.9%84.2%55-5997.9%84.2%55-5995.8%84.4%

60-6496.2%100.0%60-6492.3%100.0%60-6492.3%100.0%60-6492.3%100.0%60-64100.0%100.0%

65-6988.5%81.8%65-6992.3%81.8%65-6992.3%81.8%65-6992.3%81.8%65-6992.3%81.8%

70-7466.7%100.0%70-7466.7%100.0%70-7466.7%100.0%70-7466.7%100.0%70-7466.7%100.0%

75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%75+100.0%100.0%

Women


15-19100%85.2%82.1%82.1%82.1%73.1%Aware HIV+ status85.2%83.3%88.5%88.6%95.7%95.2%94.1%98.6%95.9%

30-34100%88.6%88.5%85.8%85.8%84.1%On ART82.1%73.9%81.6%85.8%91.3%87.8%94.1%97.1%97.9%


40-44100%95.2%95.5%89.0%87.8%92.5%

45-49100%94.1%94.1%94.1%94.1%95.5%Men

50-54100%98.6%98.6%97.1%97.1%97.1%15-1920-2425-2930-3435-3940-4445-4950-5455-59

55-59100%95.9%97.9%97.9%97.9%95.8%Aware HIV+ status69.2%60.0%55.6%83.3%85.4%84.6%92.3%86.4%94.7%

70-74100%66.7%66.7%66.7%66.7%66.7%On ART69.2%75.0%27.8%75.0%75.0%73.1%76.9%81.8%84.2%


909090

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

Women

HIV testing

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

Men

HIV testing (2)

Women

15-2930-4445- 59


On ART78.9%88.2%96.2%


Men

15-2930-4445-59


On ART48.6%74.5%80.6%


HIV testing (2)

000000

15-29

30-44

45- 59

Women

TBNumber of people

000000

15-29

30-44

45-59

Men

15-29

30-44

45- 59

%

15-29

30-44

45-59

%

Prevalence stratified by gender

Men20182013

20132018%95%CI%95%CI

15-191.80.4Overall26.424.9- 27.925.223.6- 26.9

20-244.42.6Women30.528.6- 32.530.929.0-32.9

25-2919.314.5Men18.416.3- 20.815.914.0- 18.0

30-3435.637.5

35-3945.543.6

40-4437.632.5

45-4936.638.8

50-5430.733.3

55-5916.732.2

Women

20132018

15-197.57.3

20-2425.919.2

25-2940.937.3

30-3456.544.4

35-3955.550.5

40-4449.448.8

45-4933.241.5

50-5426.634.3

55-5919.822.2

Overall

20132018

15-195.7

20-2413.3

25-2929.4

30-3442.5

35-3948.2

40-4443.6

45-4940.7

50-5434.1

55-5916.724.3

Author:infection a al naissance

Women 2013

Women 2018

Age Group

%

Men 2013

Men 2018

Age Group

%

OverallWomenMen

909090909090909090

201376.469.993.179.070.593.468.367.992.1

201890.894.895.292.296.196.485.890.290.8

Overall20132018

%95%CI

1st 9076.474.1–78.690.887.9- 93.0

2nd 9069.967.0–72.794.892.4- 96.5

3rd 9093.191.0–94.895.292.7- 96.9

Women20132018

%95%CI

1st 9079.076.4- 81.492.289.2- 94.5

2nd 9070.567.7- 73.296.193.6- 97.7

3rd 9093.491.1- 95.196.493.7- 97.9

Men20132018

%95%CI

1st 9068.363.1- 73.185.878.4- 91.0

2nd 9067.960.8- 74.290.282.7- 94.7

3rd 9092.186.0- 95.790.882.6- 95.4

Overall 15-59

OverallWomenMen


20134,59881.479.8- 82.93,11088.486.8- 89.91,48869.867.2- 72.4

20183,28696.796.1- 97.32,16498.197.4- 98.6112294.292.7- 95.4

Age groupMenWomen

15-1993.0%94.5%

20-2496.8%99.4%

25-2996.8%99.6%

30-3494.8%99.6%

35-3995.7%99.5%

40-4491.4%99.4%

45-4994.0%99.4%

50-5489.4%97.5%

55-5993.2%96.0%

Men

Women

Age Group

%

Among negative 15-59

OverallWomenMen


2013

20182,4099695.1- 96.71,49797.396.4- 98.091293.892.0- 95.2

Age groupMenWomen

15-1993.9%94.1%

20-2496.8%99.3%

25-2997.2%100.0%

30-3491.7%99.3%

35-3994.3%98.9%

40-4488.9%98.9%

45-4990.2%100.0%

50-5484.1%96.2%

55-5992.5%94.8%

Men

Women

Age Group

%

Number of people scereened with WHO questions

Number of particpants who answer at least once positively to one of the questions

Number of particpants who produce a sputum

Number of particpants with a TB resultSensitive to Izoniazid, Rifampicin, Ethambutol, Streptomycin

Number of participants who were told thay had TB

Number of participant with a current treatment

Number of participant with a previous treatment


0

10

20

30

40

50

60

70

%

Age group

2018

2013

Prevalence data Women

0

10

20

30

40

50

60

70

%

Age group

20182013

Men

Chart1

15-1915-1932.32.41.8

20-2420-244.63.83.33.1

25-2925-296.45.94.84.6

30-3430-346.166.26.4

35-3935-397.27.15.76

40-4440-447.57.47.17.1

45-4945-497.77.36.76.1

50-5450-546.96.26.15.3

55-5955-595.9564.8

2018

2013

Age group

%

7.4

7.6

19.2

26.3

37.3

41.9

44.4

57

50.5

56.7

48.8

47.7

41.5

32.7

34.3

25.4

22.2

19.9

mortality rate 15-59

Mortality rate among 15-59 2018

Among residents, XXXXX 60 adults aged 15-59 years had died in the past 12 months prior to the survey (since August 2017).

The mortality rate among the 15-59 was 12.4/1,000 persons-year (PY) overall, 7.4/1,000 PY for women and 20.6/1,000 PY for men.

HIV testing all participants

HIV testing delay among all participants 15-59 2013

WomenMenOverall

201320132013

%95%CI%95%CI%95%CI

≤ 6 months50.448.2-52.749.746.8-52.650.248.2-52.2

6- 12 months12.911.8-14.113.811.9-16.113.212.3-14.2

>12 months34.532.5-36.635.132.1-38.334.732.9-36.6

Don't know/ invalid dates2.21.7-2.81.30.8-2.11.91.5-2.4

Delay since last HIV testWomenMenTotal

n%n%n%

≤6 months82138.7327311,14836.1

>6 -12 months27312.917116.244414

>12 -24 months37017.422521.359518.7

>24 months64930.63273197630.7

Don't know100.560.6170.5

48.052.349.4

HIV testing HIV neg- no diagno

HIV testing delay among participants HIV negative or not diagnosed 15-59 2013

WomenMenOverall

201320132013

%95%CI%95%CI%95%CI

≤ 6 months58.656.1-61.15349.7-56.256.654.5-58.7

6- 12 months13.712.3-15.314.312.2-16.913.912.8-15.2

>12 months26.224.1-28.531.427.9-35.128.126.1-30.2



n%n%n%

≤6 months76450.630534.61,06944.7

>6 -12 months24716.416118.340817.1

>12 -24 months29719.720923.750621.2

>24 months1961320022.739616.6

Don't know50.360.7110.5

32.746.437.8

HIV testing coverage

HIV testing coverage 15-59 2013

2013

HIV testing rate OverallWomenMenHIV testing rate OverallWomenMenParticipants who never got a HIV test

%95%CI%95%CI%95%CI%95%CIHIV testing rate OverallWomenmen

15-1980.076.0-83.568.764.2-72.915-2980.076.0-83.568.764.2-72.9nn

20-2494.091.8-95.771.967.6-75.930-4496.294.9-97.172.469.3-75.215-1922.024.046.0

25-2997.195.0-98.471.664.7-77.645-5991.689.9-93.177.974.1-81.320-246.015.021.0

30-3498.996.8-99.774.667.9-80.325-299.016.025.0

35-3996.192.1-98.181.773.6-87.8201830-343.07.010.0

40-4496.593.4-98.279.471.8-85.3HIV testing rate OverallWomenMen35-393.05.08.0

45-4990.884.6-94.777.668.0-84.9%95%CI%95%CI40-445.06.011.0

50-5489.484.6-93.471.661.9-79.715-2997.596.3- 98.394.892.9- 96.3245-498.04.012.0

55-5983.177.9-87.378.067.2-85.930-4499.598.5- 99.894.190.6- 96.450-5414.03.017.0

total91.089.7-92.172.770.3-75.045-5997.595.8- 98.592.287.4- 95.255-5919.05.024.0

Total8985174.0

Difference

HIV testing rate OverallWomenMen

%95%CI%95%CI

15-2917.526.192.9- 96.32

30-443.321.790.6- 96.4

45-595.914.387.4- 95.2

20182018

HIV testing rate OverallWomenDiffHIV testing rate OverallMenDiff

Age grp%95%CI%95%CIAge grp%95%CI%95%CI

15-1980.076.0-83.594.591.7- 96.414.515-1968.764.2-72.993.089.8-95.324.374.4

20-2494.091.8-95.799.497.7- 99.95.420-2471.967.6-75.996.893.1- 98.624.924.8

25-2997.195.0-98.499.097.1- 99.91.925-2971.664.7-77.696.891.7- 98.825.2

30-3498.996.8-99.799.697.3- 99.90.730-3474.667.9-80.394.888.1- 97.820.2

35-3996.192.1-98.199.596.2- 99.93.435-3981.773.6-87.895.789.2- 98.414.0

40-4496.593.4-98.299.496.0- 99.92.940-4479.471.8-85.391.483.0- 95.812.0

45-4990.884.6-94.799.495.9- 99.98.645-4977.668.0-84.994.085.1- 97.716.4

50-5489.484.6-93.497.594.2- 99.08.150-5471.661.9-79.789.479.4- 94.917.8

55-5983.177.9-87.396.092.4- 97.912.955-5978.067.2-85.993.183.0- 97.415.1

total91.089.7-92.1total72.770.3-75.0

Prevalence table

Prevalence among 15-59

20182013

WomenMenTotalWomenMenTotal

n%95%CIn%(95%CIn%95%CIn%95%CIn%95%CIn%95%CI

Age groupAge group

15-19287.45.1- 10.4133.82.2-6.4415.74.2- 7.615-19587.65.8-10.0121.70.9-3.2704.93.8-6.2

20-246619.215.4- 23.852.61.1-6.27113.310.7- 16.520-2416126.323.2-29.6195.03.2-7.818017.315.3-19.5

25-298737.331.4- 43.71814.59.3-21.910529.424.9- 34.425-2920341.937.3-46.75719.816.2-24.026033.630.3-37.0

30-3411444.438.4- 50.53637.928.7- 48.015042.637.5- 47.830-3417357.050.6-63.26436.328.6-44.823749.144.6-53.6

35-399350.543.4- 57.74143.643.0- 53.813448.242.4- 54.135-3915756.750.7-62.46145.436.0-55.021853.148.1-57.9

40-448348.841.4- 56.32733.323.9- 44.311043.837.8- 50.540-4412447.740.6-54.84533.621.9-47.616834.428.9-40.3

45-496841.534.2- 49.22638.827.9- 50.99440.734.5- 47.245-498632.726.6-39.44439.229.7-49.612027.322.6-32.6

50-546934.328.1- 41.22132.322.1- 44.69033.828.4- 39.750-547525.420.1-31.53432.423.7-42.610619.115.0-24.1

55-594922.217.2- 28.1183120.5- 44672419.4- 80.655-594819.915.1-25.93116.614.3-19.26425.724.2-27.3

OverallMenWomen

95% lower95% upper95% lower95% upper95% lower95% upper

201315-19-4.94.9201315-190.93.21.50.8201315-195.8102.41.8

20-24-17.317.320-243.27.82.81.820-2423.229.63.33.1

25-29-33.633.625-2916.2244.23.625-2937.346.74.84.6

30-34-49.149.130-3428.644.88.57.730-3450.663.26.26.4

35-39-53.153.135-3936559.69.435-3950.762.45.76.0

40-44-34.434.440-4421.947.614.011.740-4440.654.87.17.1

45-49-27.327.345-4929.749.610.49.545-4926.639.46.76.1

50-54-19.119.150-5423.742.610.28.750-5420.131.56.15.3

55-59-25.725.755-5914.319.22.62.355-5915.125.96.04.8

201815-194.27.61.91.5201815-192.26.42.61.6201815-195.110.43.02.3

20-2410.716.53.22.620-241.16.23.61.520-2415.423.84.63.8

25-2924.934.454.525-299.321.97.45.225-2931.443.76.45.9

30-3437.547.85.25.130-3428.748.010.19.230-3438.450.56.16.0

35-3942.454.15.95.835-3934.053.810.29.635-3943.457.77.27.1

40-4437.850.56.7640-4423.944.311.09.440-4441.456.37.57.4

45-4934.547.26.56.245-4927.950.912.110.945-4934.249.27.77.3

50-5428.439.75.95.450-5422.144.612.310.250-5428.141.26.96.2

55-5919.480.656.64.655-5920.544.013.010.555-5917.228.15.95.0

Prevalence table (2)


2018

WomenMenTotal

Age group20182013Age group20182013Age group20182013

15-197.47.615-193.81.715-195.74.9

20-2419.226.320-242.65.020-2413.317.3

25-2937.341.925-2914.519.825-2929.433.6

30-3444.457.030-3437.936.330-3442.649.1

35-3950.556.735-3943.645.435-3948.253.1

40-4448.847.740-4433.333.640-4443.834.4

45-4941.532.745-4938.839.245-4940.727.3

50-5434.325.450-5432.332.450-5433.819.1

55-5922.219.955-593116.655-592425.7

OverallMenWomen


201315-1900201315-190.93.21.50.8201315-195.8102.41.8

20-240020-243.27.82.81.820-2423.229.63.33.1

25-290025-2916.2244.23.625-2937.346.74.84.6

30-340030-3428.644.88.57.730-3450.663.26.26.4

35-390035-3936559.69.435-3950.762.45.76.0

40-440040-4421.947.614.011.740-4440.654.87.17.1

45-490045-4929.749.610.49.545-4926.639.46.76.1

50-540050-5423.742.610.28.750-5420.131.56.15.3

55-590055-5914.319.22.62.355-5915.125.96.04.8

201815-194.27.61.91.5201815-192.26.42.61.6201815-195.110.43.02.3

20-2410.716.53.22.620-241.16.23.61.520-2415.423.84.63.8

25-2924.934.454.525-299.321.97.45.225-2931.443.76.45.9

30-3437.547.85.25.130-3428.748.010.19.230-3438.450.56.16.0

35-3942.454.15.95.835-3934.053.810.29.635-3943.457.77.27.1

40-4437.850.56.7640-4423.944.311.09.440-4441.456.37.57.4

45-4934.547.26.56.245-4927.950.912.110.945-4934.249.27.77.3

50-5428.439.75.95.450-5422.144.612.310.250-5428.141.26.96.2

55-5919.480.656.64.655-5920.544.013.010.555-5917.228.15.95.0


32.32.41.8

4.63.83.33.1

6.45.94.84.6

6.166.26.4

7.27.15.76

7.57.47.17.1

7.77.36.76.1

6.96.26.15.3

5.9564.8

2018

2013

Prevalence 2

2013

median age of HIV participants34 (27-42)

median age of HIV women33 (26-42)

median age of HIV men36 (29-44)

Status awareness

Status awareness 20132018

awareWomenMenTotal

%95%CI%95%CI%95%CIWomenMen

15-2968.4%(54.7-79.4)61.0%29.9-85.167.254.5-77.815-29 years85.6%79.2- 90.0%61.1%44.4- 75.5

30-4469.4%(65.3-73.2)51.6%43.2-59.965.561.7-69.230-44 years93.1%89.5- 95.5%85.6%77.4- 91.2

45-5988.5%(85.2-91.2)78.8%70.9-85.0%85.882.1-88.845- 59 years96.8%93.0- 98.6%90.8%80.8- 95.2

Diff

17.2%0.1%

23.7%34.0%

8.3%12.0%

ART coverage

2013

ART coverage among all hiv positiveWomenMenTotal2018Diff

%95%CI%95%CI%95%CIWomenMenWomenMen

15-2934.6%23.7-47.226.8%9.5-56.3%33.3%23.7-44.415-29 years79.4%47.2%44.8%13.9%

30-4444.4%39.7-49.130.0%23.5-37.4%41.3%37.3-45.430-44 years88.2%75.5%43.8%34.2%

45-5970.0%65.9-73.959.0%50.2-67.2%67.0%62.6-71.145- 59 years96.2%80.0%26.2%13.0%

2nd 90

ART coverage among the ones who knew their statusWomenMenTotal

%95%CI%95%CI%95%CI

15-2949.1%33.3-65.144.0%19.0-72.5%48.4%34.4-62.6

30-4462.8%56.5-68.658.1%44.9-70.262.0%55.8-67.8

45-5978.6%74.5-82.275.2%66.8-82.1%77.7%73.7-81.3

VLS

VLS among all HIV positive 20132018Diff

VLSWomenMenTotalVLSWomenMen

%95%CI%95%CI%95%CI%95%CI%95%CIWomenMen

15-2934.5%23.6-47.226.8%9.5-56.333.2%23.7-44.315-2975.6%68.6-81.4%51.5%34.8- 67.9%41.1%18.3%

30-4451.3%46.7-55.931.0%24.2-38.946.9%43.0-50.830-4488.3%84.0- 91.6%75.5%66.2- 82.9%37.0%28.6%

45-5960.4%57.6-63.158.1%49.2-66.568.9%64.6-72.945-5996.2%92.2- 98.2%79.7%68.0- 87.9%35.8%10.8%

3rd 90

VLS among participants on art

VLSWomenMenTotal

%95%CI%95%CI%95%CI

15-2982.0%57.9-93.8100.0%84.462.0-94.7

30-4492.5%88.3-95.389.0%71.8-96.39287.6-94.9

45-5994.6%91.6-96.693.4%85.8-97.1%94.391.5-96.3

Sheet1

Chart1

15-1915-192.61.61.50.8

20-2420-243.61.52.81.8

25-2925-297.45.24.23.6

30-3430-3410.19.28.57.7

35-3935-3910.29.69.69.4

40-4440-44119.41411.7

45-4945-4912.110.910.49.5

50-5450-5412.310.210.28.7

55-5955-591310.52.62.3

2018

2013

Age group

%

3.8

1.7

2.6

5

14.5

19.8

37.9

36.3

43.6

45.4

33.3

33.6

38.8

39.2

32.3

32.4

31

16.6

mortality rate 15-59

Mortality rate among 15-59 2018

Among residents, XXXXX 60 adults aged 15-59 years had died in the past 12 months prior to the survey (since August 2017).

The mortality rate among the 15-59 was 12.4/1,000 persons-year (PY) overall, 7.4/1,000 PY for women and 20.6/1,000 PY for men.

HIV testing all participants

HIV testing delay among all participants 15-59 2013

WomenMenOverall

201320132013

%95%CI%95%CI%95%CI

≤ 6 months50.448.2-52.749.746.8-52.650.248.2-52.2

6- 12 months12.911.8-14.113.811.9-16.113.212.3-14.2

>12 months34.532.5-36.635.132.1-38.334.732.9-36.6



n%n%n%

≤6 months82138.7327311,14836.1

>6 -12 months27312.917116.244414

>12 -24 months37017.422521.359518.7

>24 months64930.63273197630.7

Don't know100.560.6170.5

48.052.349.4

HIV testing HIV neg- no diagno

HIV testing delay among participants HIV negative or not diagnosed 15-59 2013

WomenMenOverall

201320132013

%95%CI%95%CI%95%CI

≤ 6 months58.656.1-61.15349.7-56.256.654.5-58.7

6- 12 months13.712.3-15.314.312.2-16.913.912.8-15.2

>12 months26.224.1-28.531.427.9-35.128.126.1-30.2



n%n%n%

≤6 months76450.630534.61,06944.7

>6 -12 months24716.416118.340817.1

>12 -24 months29719.720923.750621.2

>24 months1961320022.739616.6

Don't know50.360.7110.5

32.746.437.8

HIV testing coverage

HIV testing coverage 15-59 2013

2013

HIV testing rate OverallWomenMenHIV testing rate OverallWomenMenParticipants who never got a HIV test

%95%CI%95%CI%95%CI%95%CIHIV testing rate OverallWomenmen

15-1980.076.0-83.568.764.2-72.915-2980.076.0-83.568.764.2-72.9nn

20-2494.091.8-95.771.967.6-75.930-4496.294.9-97.172.469.3-75.215-1922.024.046.0

25-2997.195.0-98.471.664.7-77.645-5991.689.9-93.177.974.1-81.320-246.015.021.0

30-3498.996.8-99.774.667.9-80.325-299.016.025.0

35-3996.192.1-98.181.773.6-87.8201830-343.07.010.0

40-4496.593.4-98.279.471.8-85.3HIV testing rate OverallWomenMen35-393.05.08.0

45-4990.884.6-94.777.668.0-84.9%95%CI%95%CI40-445.06.011.0

50-5489.484.6-93.471.661.9-79.715-2997.596.3- 98.394.892.9- 96.3245-498.04.012.0

55-5983.177.9-87.378.067.2-85.930-4499.598.5- 99.894.190.6- 96.450-5414.03.017.0

total91.089.7-92.172.770.3-75.045-5997.595.8- 98.592.287.4- 95.255-5919.05.024.0

Total8985174.0

Difference

HIV testing rate OverallWomenMen

%95%CI%95%CI

15-2917.526.192.9- 96.32

30-443.321.790.6- 96.4

45-595.914.387.4- 95.2

20182018

HIV testing rate OverallWomenDiffHIV testing rate OverallMenDiff

Age grp%95%CI%95%CIAge grp%95%CI%95%CI

15-1980.076.0-83.594.591.7- 96.414.515-1968.764.2-72.993.089.8-95.324.374.4

20-2494.091.8-95.799.497.7- 99.95.420-2471.967.6-75.996.893.1- 98.624.924.8

25-2997.195.0-98.499.097.1- 99.91.925-2971.664.7-77.696.891.7- 98.825.2

30-3498.996.8-99.799.697.3- 99.90.730-3474.667.9-80.394.888.1- 97.820.2

35-3996.192.1-98.199.596.2- 99.93.435-3981.773.6-87.895.789.2- 98.414.0

40-4496.593.4-98.299.496.0- 99.92.940-4479.471.8-85.391.483.0- 95.812.0

45-4990.884.6-94.799.495.9- 99.98.645-4977.668.0-84.994.085.1- 97.716.4

50-5489.484.6-93.497.594.2- 99.08.150-5471.661.9-79.789.479.4- 94.917.8

55-5983.177.9-87.396.092.4- 97.912.955-5978.067.2-85.993.183.0- 97.415.1

total91.089.7-92.1total72.770.3-75.0

Prevalence table


20182013

WomenMenTotalWomenMenTotal

n%95%CIn%(95%CIn%95%CIn%95%CIn%95%CIn%95%CI

Age groupAge group

15-19287.45.1- 10.4133.82.2-6.4415.74.2- 7.615-19587.65.8-10.0121.70.9-3.2704.93.8-6.2

20-246619.215.4- 23.852.61.1-6.27113.310.7- 16.520-2416126.323.2-29.6195.03.2-7.818017.315.3-19.5

25-298737.331.4- 43.71814.59.3-21.910529.424.9- 34.425-2920341.937.3-46.75719.816.2-24.026033.630.3-37.0

30-3411444.438.4- 50.53637.928.7- 48.015042.637.5- 47.830-3417357.050.6-63.26436.328.6-44.823749.144.6-53.6

35-399350.543.4- 57.74143.643.0- 53.813448.242.4- 54.135-3915756.750.7-62.46145.436.0-55.021853.148.1-57.9

40-448348.841.4- 56.32733.323.9- 44.311043.837.8- 50.540-4412447.740.6-54.84533.621.9-47.616834.428.9-40.3

45-496841.534.2- 49.22638.827.9- 50.99440.734.5- 47.245-498632.726.6-39.44439.229.7-49.612027.322.6-32.6

50-546934.328.1- 41.22132.322.1- 44.69033.828.4- 39.750-547525.420.1-31.53432.423.7-42.610619.115.0-24.1

55-594922.217.2- 28.1183120.5- 44672419.4- 80.655-594819.915.1-25.93116.614.3-19.26425.724.2-27.3

OverallMenWomen


201315-19-4.94.9201315-190.93.21.50.8201315-195.8102.41.8

20-24-17.317.320-243.27.82.81.820-2423.229.63.33.1

25-29-33.633.625-2916.2244.23.625-2937.346.74.84.6

30-34-49.149.130-3428.644.88.57.730-3450.663.26.26.4

35-39-53.153.135-3936559.69.435-3950.762.45.76.0

40-44-34.434.440-4421.947.614.011.740-4440.654.87.17.1

45-49-27.327.345-4929.749.610.49.545-4926.639.46.76.1

50-54-19.119.150-5423.742.610.28.750-5420.131.56.15.3

55-59-25.725.755-5914.319.22.62.355-5915.125.96.04.8

201815-194.27.61.91.5201815-192.26.42.61.6201815-195.110.43.02.3

20-2410.716.53.22.620-241.16.23.61.520-2415.423.84.63.8

25-2924.934.454.525-299.321.97.45.225-2931.443.76.45.9

30-3437.547.85.25.130-3428.748.010.19.230-3438.450.56.16.0

35-3942.454.15.95.835-3934.053.810.29.635-3943.457.77.27.1

40-4437.850.56.7640-4423.944.311.09.440-4441.456.37.57.4

45-4934.547.26.56.245-4927.950.912.110.945-4934.249.27.77.3

50-5428.439.75.95.450-5422.144.612.310.250-5428.141.26.96.2

55-5919.480.656.64.655-5920.544.013.010.555-5917.228.15.95.0



2018

WomenMenTotal

Age group20182013Age group20182013Age group20182013

15-197.47.615-193.81.715-195.74.9

20-2419.226.320-242.65.020-2413.317.3

25-2937.341.925-2914.519.825-2929.433.6

30-3444.457.030-3437.936.330-3442.649.1

35-3950.556.735-3943.645.435-3948.253.1

40-4448.847.740-4433.333.640-4443.834.4

45-4941.532.745-4938.839.245-4940.727.3

50-5434.325.450-5432.332.450-5433.819.1

55-5922.219.955-593116.655-592425.7

OverallMenWomen


201315-1900201315-190.93.21.50.8201315-195.8102.41.8

20-240020-243.27.82.81.820-2423.229.63.33.1

25-290025-2916.2244.23.625-2937.346.74.84.6

30-340030-3428.644.88.57.730-3450.663.26.26.4

35-390035-3936559.69.435-3950.762.45.76.0

40-440040-4421.947.614.011.740-4440.654.87.17.1

45-490045-4929.749.610.49.545-4926.639.46.76.1

50-540050-5423.742.610.28.750-5420.131.56.15.3

55-590055-5914.319.22.62.355-5915.125.96.04.8

201815-194.27.61.91.5201815-192.26.42.61.6201815-195.110.43.02.3

20-2410.716.53.22.620-241.16.23.61.520-2415.423.84.63.8

25-2924.934.454.525-299.321.97.45.225-2931.443.76.45.9

30-3437.547.85.25.130-3428.748.010.19.230-3438.450.56.16.0

35-3942.454.15.95.835-3934.053.810.29.635-3943.457.77.27.1

40-4437.850.56.7640-4423.944.311.09.440-4441.456.37.57.4

45-4934.547.26.56.245-4927.950.912.110.945-4934.249.27.77.3

50-5428.439.75.95.450-5422.144.612.310.250-5428.141.26.96.2

55-5919.480.656.64.655-5920.544.013.010.555-5917.228.15.95.0


32.32.41.8

4.63.83.33.1

6.45.94.84.6

6.166.26.4

7.27.15.76

7.57.47.17.1

7.77.36.76.1

6.96.26.15.3

5.9564.8

2018

2013

Prevalence 2

2.61.61.50.8

3.61.52.81.8

7.45.24.23.6

10.19.28.57.7

10.29.69.69.4

119.41411.7

12.110.910.49.5

12.310.210.28.7

1310.52.62.3

2018

2013

Men

Status awareness

2013

median age of HIV participants34 (27-42)

median age of HIV women33 (26-42)

median age of HIV men36 (29-44)

ART coverage

Status awareness 20132018

awareWomenMenTotal

%95%CI%95%CI%95%CIWomenMen

15-2968.4%(54.7-79.4)61.0%29.9-85.167.254.5-77.815-29 years85.6%79.2- 90.0%61.1%44.4- 75.5

30-4469.4%(65.3-73.2)51.6%43.2-59.965.561.7-69.230-44 years93.1%89.5- 95.5%85.6%77.4- 91.2

45-5988.5%(85.2-91.2)78.8%70.9-85.0%85.882.1-88.845- 59 years96.8%93.0- 98.6%90.8%80.8- 95.2

Diff

17.2%0.1%

23.7%34.0%

8.3%12.0%

VLS

2013

ART coverage among all hiv positiveWomenMenTotal2018Diff

%95%CI%95%CI%95%CIWomenMenWomenMen

15-2934.6%23.7-47.226.8%9.5-56.3%33.3%23.7-44.415-29 years79.4%47.2%44.8%13.9%

30-4444.4%39.7-49.130.0%23.5-37.4%41.3%37.3-45.430-44 years88.2%75.5%43.8%34.2%

45-5970.0%65.9-73.959.0%50.2-67.2%67.0%62.6-71.145- 59 years96.2%80.0%26.2%13.0%

2nd 90

ART coverage among the ones who knew their statusWomenMenTotal

%95%CI%95%CI%95%CI

15-2949.1%33.3-65.144.0%19.0-72.5%48.4%34.4-62.6

30-4462.8%56.5-68.658.1%44.9-70.262.0%55.8-67.8

45-5978.6%74.5-82.275.2%66.8-82.1%77.7%73.7-81.3

Sheet1

VLS among all HIV positive 20132018Diff

VLSWomenMenTotalVLSWomenMen

%95%CI%95%CI%95%CI%95%CI%95%CIWomenMen

15-2934.5%23.6-47.226.8%9.5-56.333.2%23.7-44.315-2975.6%68.6-81.4%51.5%34.8- 67.9%41.1%18.3%

30-4451.3%46.7-55.931.0%24.2-38.946.9%43.0-50.830-4488.3%84.0- 91.6%75.5%66.2- 82.9%37.0%28.6%

45-5960.4%57.6-63.158.1%49.2-66.568.9%64.6-72.945-5996.2%92.2- 98.2%79.7%68.0- 87.9%35.8%10.8%

3rd 90

VLS among participants on art

VLSWomenMenTotal

%95%CI%95%CI%95%CI

15-2982.0%57.9-93.8100.0%84.462.0-94.7

30-4492.5%88.3-95.389.0%71.8-96.39287.6-94.9

45-5994.6%91.6-96.693.4%85.8-97.1%94.391.5-96.3


Incidence data


Conclusions • It is feasible to achieve the 90-90-90 targets • MSF activities and national level policy changes contributed to

dramatic increase in viral suppression and ART coverage at the population level

• Community-based interventions were successful across the treatment cascade

• Data suggests a reduction of incidence at population level Similar trends have been reported in two other surveys

Ongoing challenges: • Males remain ‘hard to reach’ especially for first two ’90s’; • Adolescent girls and young womens remain at risk.


Acknowledgements All the study participants and the Mbongolwane

Community

MHIPS team

Mbongolwane/ Eshowe team

MSF South Africa

DoH

MSF OCB

Epicentre

SAMU

CLS and NICD laboratories

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