PUBLISHED ON 10 Mar 2014


RUSH-funded research by Harvard University’s Till Barnighausen was presented at the Conference On Retroviruses And Opportunistic Infections, showing male life expectancy in rural South Africa improving far less dramatically than female life expectancy since the introduction of antiretroviral therapy.

Women have suffered the disproportionate burden of HIV infection. However, with the scale-up of antiretroviral therapy (ART), women have been found to have higher rates of HIV testing, start on antiretroviral treatment earlier, have better adherence and retention to treatment, and better clinical prognosis.

stencil_questionmarksThis study by Harvard School of Public Health Associate Professor of Global Health Till Barnighausen, funded by RUSH, was the first to assess the implication of ART scale-up on sex-disparities in all-cause and HIV-specific mortality at the population level.

Demographic data on 54,477 women and 46,809 men were collected by health and demographic surveillance at the Africa Centre for Health and Population Studies for the period 2000-2011 for all members of all households in a large rural district in KwaZulu-Natal.

The Hlabisa district has seen intensive studies into the impact of antiretroviral therapy in Africa, with seven per cent of all adults in the area receiving antiretroviral therapy by 2012. As a result, overall life expectancy has risen by one year for each year that antiretroviral therapy has been available since 2004.

However, although male life expectancy increased by nine years between 2004 and 2011, men were 25% more likely than women to die of an HIV-related illness in 2011. Women’s life expectancy increased by 13.2 years and the gap between male and female life expectancy increased from 4.5 years to 9 years.

The study showed that 57% of deaths in HIV-positive men between 2000 and 2011 occurred before men had sought any form of HIV care, compared to 41% in women.

The proportion of men with HIV who die before seeking care has changed little since 2007, while the proportion of women with HIV who die before accessing care has declined progressively in each year since 2006.

Watch the Webcast of the CROI Presentation