Estimating the impact of expanded access to antiretroviral therapy on maternal, paternal and double orphans in sub-Saharan Africa, 2009-2020.docVIP

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Estimating the impact of expanded access to antiretroviral therapy on maternal, paternal and double orphans in sub-Saharan Africa, 2009-2020.doc

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Estimating the impact of expanded access to antiretroviral therapy on maternal, paternal and double orphans in sub-Saharan Africa, 2009-2020

Anemaetal.AIDSResearchandTherapy2011,8:13 /content/8/1/13 RESEARCH OpenAccess Estimatingtheimpactofexpandedaccessto antiretroviraltherapyonmaternal,paternaland doubleorphansinsub-SaharanAfrica,2009-2020 ArankaAnema1,2*,ChristopherGAu-Yeung1,MichelJoffres3,AngelaKaida3,KrisztinaVasarhelyi3,4,SteveKanters1,3, JulioSGMontaner1,2,RobertSHogg1,3 Abstract Background:HIV/AIDShasorphaned11.6millionchildreninsub-SaharanAfrica.Expandedantiretroviraltherapy (ART)usemayreduceAIDSorphanhoodbydecreasingadultmortalityandpopulation-levelHIVtransmission. Methods:WemodeledtwoscenariostomeasuretheimpactofadultARTuseontheincidenceoforphanhoodin 10sub-SaharanAfricancountries,from2009to2020.Demographicmodeldatainputswereobtainedfromcohort studies,UNAIDS,UNPopulationDivision,WHOandtheUSCensusBureau. Results:ComparedtocurrentratesofARTuptake,universalARTaccessaverted4.37millionmoreAIDSorphansby year2020,including3.15millionmaternal,1.89millionpaternaland0.75milliondoubleorphans.Thenumberof AIDSorphansavertedwashighestinSouthAfrica(901.71thousand)andNigeria(839.01thousand),andlowestin Zimbabwe(86.96thousand)andC?ted’Ivoire(109.12thousand). Conclusion:UniversalARTusemaysignificantlyreduceorphanhoodinsub-SaharanAfrica. Introduction Agrowingbodyofempiricalevidenceandmathematical Anestimated11.6millionchildren(aged0to17years) modelingsuggeststhatexpandedARTusemayalsopre- insub-SaharanAfricahavelostoneorbothparentsdue vent population-level transmission ofHIV [11-14]. In to human immunodeficiency virus/acquired immune sub-SaharanAfrica,44%(2.925million)ofpeopleclini- deficiencysyndrome(HIV/AIDS)sincethebeginningof callyeligiblefortreatmentwerereceivingitattheendof the epidemic [1]. Studies suggest that orphans in sub- 2008[15]. Several studies haveevaluated theimpact of SaharanAfricamayhavepoorqualityoflifeandhealth, the AIDS epidemic onorphanhood [15,16]. However, including reduced access to basic material goods and nonetodatehaveexaminedthisinthecontextofefforts reten