Page 265 - HIVMED_v21_i1.indb

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 8 Original Research

Changes in the incidence and prevalence of human

immunodeficiency virus or acquired immunodeficiency

syndrome in the South African medical schemes

environment: 2005–2015

Authors: Background: The South African (SA) private medical schemes environment has over the past
Floidy Wafawanaka two decades respond to the evolving needs of people living with the human immunodeficiency
1
Martha S. Lubbe 1
Irma Kotzé virus (PLWH) or acquired immunodeficiency syndrome (AIDS).
1
Marike Cockeran 2
Objective: To determine changes in the incidence and prevalence rate of human
Affiliations: immunodeficiency virus (HIV) or AIDS in the SA private medical schemes environment from
1 Medicine Usage in South 2005 to 2015.
Africa (MUSA), Faculty of
Health Sciences, North-West Method: In this observational study, a single, pharmaceutical benefit management (PBM)
University, Potchefstroom, company’s medicine-claims database of members with HIV or AIDS has been retrospectively
South Africa analysed from January 2005 to December 2015. The cohort includes all patients identified by
the HIV or AIDS-related diagnostic ICD-10 codes, B20-B24, who also claimed antiretroviral
2 Department of Statistics,
School of Computer, Statistical medication during that period.
and Mathematical Sciences,
North-West University, Results: From 2005 to 2015, the proportion of HIV or AIDS patients enrolled in the PBM-
Potchefstroom, South Africa company increased from 0.63% to 2.10%, and the incidence rate of new cases among the
beneficiaries increased 2.3 times. The highest HIV or AIDS prevalence and incidence rates
Corresponding author: were found in the age group ≥ 40 and < 60 years, followed by the age group ≥ 60 and < 70
Martha Lubbe,
[email protected] years. The highest prevalence rates in 2015 were recorded in Gauteng, namely, 422.4/1000
beneficiaries, followed by Western Cape (149.4/1000), and KwaZulu-Natal (118.4/1000).
Dates:
Received: 06 July 2019 Conclusion: There has been an increase in the number of SA-PLWH accessing treatment in the
Accepted: 05 Feb. 2020 medical scheme environment. The high prevalence of HIV infection among older members
Published: 29 June 2020 should signal concern that HIV-related comorbid conditions are likely to become a growing
component of care required by PLWH utilizing the SA private healthcare sector.
How to cite this article:
Wafawanaka F, Lubbe MS. Keywords: incidence; prevalence; HIV or AIDS; medical schemes; South Africa.
KotzéI, Cockeran M. Changes

in the incidence and
prevalence of human
immunodeficiency virus or Introduction
acquired immunodeficiency
syndrome in the South Human immunodeficiency virus or acquired immunodeficiency syndrome (HIV or AIDS) is a
African medical schemes significant cause of death in Africa, and the fourth-largest cause of death worldwide. Access to
1,2
environment: 2005–2015. antiretroviral treatment (ART) in the South Africa’s public healthcare sector is carefully monitored,
3
S Afr J HIV Med. 2020;21(1), yet much remains unknown regarding the number of HIV-positive individuals on ART outside
a1007. https://doi.org/10.
4
4
4102/sajhivmed.v21i1.1007 this sector. The South African Medical Schemes Act, No. 131 of 1998, ensures that the diagnostic
and treatment costs of specified medical conditions are addressed in the so-called, ‘prescribed
Copyright: minimum benefits (PMBs)’ regardless of the benefit-option selected by the member. Prescribed
4,5
© 2020. The Authors. minimum benefits cover conditions that meet the definition of a medical emergency, certain
Licensee: AOSIS. This work
is licensed under the specifically defined medical conditions (n = 270) and additional chronic conditions (n = 26) as per
Creative Commons the Chronic Disease’ List (CDL). Furthermore, medical aid schemes in South Africa have a legal
4,5
Attribution License. obligation to provide PMBs to their members with HIV or AIDS and to pay in full without recourse
to co-payment or deductibles. Since 2005, ART has been included as part of PMBs. These
4,5
4,5
benefits also cover HIV voluntary counselling and testing, pain management in palliative care,
preventive therapies, hospitalisation and treatment for HIV or AIDS-related opportunistic
Read online: conditions. 4,5
Read online:
Scan this QR
Scan this QR
code with your
code with your
smart phone or
smart phone or Before 2005, South Africans (SAs) obtained ART privately through disease-management,
mobile device
mobile device workplace or community treatment programmes. In 2004, the SA public sector started providing
5,6
to read online.
to read online.
ART to its citizens, and whilst ART has resulted in the global decrease of new HIV infections, it
http://www.sajhivmed.org.za 257 Open Access