The scale-up of antiretroviral therapy (ART) programmes in Lusaka, Zambia, has been accompanied by only modest reductions in the city’s mortality rates, investigators report in the Bulletin of the World Health Organization. A series of cross-sectional household surveys conducted between 2004 and 2011 showed no significant reduction in the mortality rate.
The authors admit this finding was “unexpected” and highlights the importance of further increasing roll-out of therapy and supporting people to adhere to their treatment and remain in care. More encouragingly, the proportion of households with an orphaned child declined and there was also evidence that knowledge of HIV improved.
Thanks to ART, many people living with HIV now have a normal life expectancy. Excellent outcomes have been observed in people taking ART in sub-Saharan Africa. It is hoped that increased access to ART will translate into reductions in all-cause mortality in countries with generalised HIV epidemics. Short-term data from several southern African settings suggest this is the case.
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