Challenges with using estimates when calculating ART need among adults in South Africa.

BACKGROUND: The Foundation for Professional Development (FPD) collects information annually on HIV/AIDS service provision and estimates service needs in the City of Tshwane Metropolitan Municipality (CTMM). METHODS: Antiretroviral therapy (ART) data from the Department of Health and Statistics South Africa (SSA) mid-year population estimates were used to approximate the ART need among adults in the CTMM. RESULTS: According to SSA data, ART need decreased dramatically from 2010 to 2011 and was lower than the number of adults receiving ART. Although the noted difference was probably due to changes in the calculations by SSA, no detailed or confirmed explanation could be offered. CONCLUSIONS: We provide a constructive contribution to the discussion about the use of model-derived estimates of ART need.

Provision and need of HIV/AIDS services in the City of Tshwane Metropolitan Municipality, 2010.

OBJECTIVES: To determine the need for HIV/AIDS service provision in the City of Tshwane Metropolitan Municipality (CTMM), especially in municipal areas. METHODS: The Foundation for Professional Development initiated the Compass Project. Using a questionnaire, data were collected during May - June 2010 from organisations providing HIV/AIDS services in the CTMM (organisational information and types of HIV/AIDS services). The need for HIV counselling and testing (HCT), antiretroviral treatment (ART), prevention of mother-to-child transmission (PMTCT), and care for orphans and vulnerable children (OVC) was estimated using data from various sources. RESULTS: A total of 447 service providers was included in the study: 72.3% non-governmental organisations (NGOs); 18.1% in the public sector; 5.1% in the private sector; and 4.5% faith-based organisations. The majority of the prevention- (70.2%) and support-related services (77.4%) were provided by NGOs, while the majority of treatment-related services originated from the public sector (57.3%). Service need estimates included: HCT - 1 435 438 adults aged 15 - 49 years (11 127/service provider); total ART - 75 211 adults aged 15+ years (1 213/service provider); ART initiation - 30 713 adults aged 15+ years (495/service provider); PMTCT-HCT - 30 092 pregnant women (510/service provider); PMTCT-ART - 7 734 HIV+ pregnant women (221/service provider); and OVC care - 54 590 children (258/service provider). CONCLUSIONS: Service gaps remain in the provision of HCT, PMTCT-ART and OVC care. ART provision must be increased, in light of new treatment guidelines from the Department of Health.