BACKGROUND: Youth between the ages of 15 years to 24 years account for almost half of new HIV infections in South Africa OBJECTIVES: To describe the study details of the Botsha Bophelo Adolescent Health Study (BBAHS) which was an investigation of HIV risk among adolescents living in Soweto, South Africa METHODS: Eligibility criteria for the BBAHS included being 14 years - 19 years old and living in one of the 41 identified formal and informal areas in the township of Soweto. A cross-sectional survey was developed between investigators and an adolescent community advisory board consisting of previously validated scales and original questions including demographics, sexual and reproductive health, health service utilisation and psychosocial behaviours RESULTS: Between 2010 and 2012, interviewers administered surveys among 830 adolescents (57% females), whose median age was 17 years (Q1, Q3: 16, 18), and found that 43% of participants identified their ethnicity as Zulu, 52% reported high food insecurity, 37% reported at least one parent had died, 15% reported living in a shack and 83% identified as heterosexual. Over half of the participants (55%) reported ever having sex (49% of females and 64% of males), 11% of whom initiated sex at < 15 years of age (3% females and 21% males). Almost half (47%) reported ever testing for HIV, 3% (n = 12) of whom self-reported being HIV-positive and 33% (n = 4) were on antiretroviral therapy CONCLUSION: Our study highlights important individual, relational and structural level determinants of HIV risk for adolescent men and women growing up within HIV hyperendemic settings

Procedeu-se a uma revisão abrangente de artigos publicados entre 1996-2006, período posterior à introdução da terapia anti-retroviral de alta potência (HAART) no Brasil. Foram revisados artigos disponíveis nas bases de dados MEDLINE e SciELO, a partir de combinações de palavras-chave que contemplam os principais temas na área do tratamento e manejo da AIDS na era pós-HAART: doenças oportunistas e co-infecções, aderência à terapia, sobrevida pré e pós-HAART, eventos adversos e efeitos colaterais, emergência e eventual transmissão de cepas virais resistentes e complicações cardiovasculares e metabólicas, além de questões relativas ao acesso e à eqüidade. Em suma, observa-se uma transformação profunda no campo da AIDS no período pós-HAART, com aumento dramático da sobrevida e da qualidade de vida, e redução expressiva dos episódios de doenças oportunistas. Por outro lado, novas questões se colocam, como a relevância das co-infecções de evolução lenta, como a hepatite C, os distúrbios metabólicos e cardiovasculares, e o desafio posto pela emergência de cepas resistentes, com repercussões individuais (falha virológica) e coletivas (resistência primária e secundária em nível da comunidade) e, conseqüente, aumento de custos da terapia.

A review was carried out of papers published between 1996 and 2006, documenting the introduction of highly active anti-retroviral therapy (HAART) in Brazil. Papers indexed in the MEDLINE and SciELO databases were retrieved using different combinations of keywords related to the management and care of AIDS in the post-HAART era: opportunistic diseases and co-infections, adherence to therapy, survival in the pre- and post-HAART eras, adverse events and side-effects, emergence and possible transmission of resistant viral strains, metabolic and cardiovascular disorders, and issues related to access to care and equity. The review documents the dramatic changes in HIV/AIDS disease progression in the post-HAART era, including an increase in survival and quality of life and a pronounced decrease in the episodes of opportunistic diseases. Notwithstanding such major achievements, new challenges have emerged, including slow evolving co-infections (such as hepatitis C, metabolic and cardiovascular disorders), the emergence of viral resistance, with consequences at the individual level (virological failure) and the community level (primary/secondary resistance at the population level), and impacts on the cost of new therapeutic regimens.

Procedeu-se a uma revisão abrangente de artigos publicados entre 1996-2006, período posterior à introdução da terapia anti-retroviral de alta potência (HAART) no Brasil. Foram revisados artigos disponíveis nas bases de dados MEDLINE e SciELO, a partir de combinações de palavras-chave que contemplam os principais temas na área do tratamento e manejo da AIDS na era pós-HAART: doenças oportunistas e co-infecções, aderência à terapia, sobrevida pré e pós-HAART, eventos adversos e efeitos colaterais, emergência e eventual transmissão de cepas virais resistentes e complicações cardiovasculares e metabólicas, além de questões relativas ao acesso e à eqüidade. Em suma, observa-se uma transformação profunda no campo da AIDS no período pós-HAART, com aumento dramático da sobrevida e da qualidade de vida, e redução expressiva dos episódios de doenças oportunistas. Por outro lado, novas questões se colocam, como a relevância das co-infecções de evolução lenta, como a hepatite C, os distúrbios metabólicos e cardiovasculares, e o desafio posto pela emergência de cepas resistentes, com repercussões individuais (falha virológica) e coletivas (resistência primária e secundária em nível da comunidade) e, conseqüente, aumento de custos da terapia.

A review was carried out of papers published between 1996 and 2006, documenting the introduction of highly active anti-retroviral therapy (HAART) in Brazil. Papers indexed in the MEDLINE and SciELO databases were retrieved using different combinations of keywords related to the management and care of AIDS in the post-HAART era: opportunistic diseases and co-infections, adherence to therapy, survival in the pre- and post-HAART eras, adverse events and side-effects, emergence and possible transmission of resistant viral strains, metabolic and cardiovascular disorders, and issues related to access to care and equity. The review documents the dramatic changes in HIV/AIDS disease progression in the post-HAART era, including an increase in survival and quality of life and a pronounced decrease in the episodes of opportunistic diseases. Notwithstanding such major achievements, new challenges have emerged, including slow evolving co-infections (such as hepatitis C, metabolic and cardiovascular disorders), the emergence of viral resistance, with consequences at the individual level (virological failure) and the community level (primary/secondary resistance at the population level), and impacts on the cost of new therapeutic regimens.