South African life expectancy and antiretroviral therapy (ART) coverage, 1990–2015 [2].

<p>South African life expectancy and antiretroviral therapy (ART) coverage, 1990–2015 [<a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1002469#pmed.1002469.ref002" target="_blank">2</a>].</p

Trajectory of ART coverage in South Africa if human resources for treating HIV/AIDS (HRHA) were to stay constant at the initial level.

<p>Coverage shown for the following cases: assuming ART does not have prevention effects; assuming ART prevention effects are as observed in the HPTN 052 trial; ART prevention effects that are 1/2 or 1/10th of that observed in the HPTN 052 trial; and assuming ART non-retention rate is 30% or 50%. The lines for the following three cases are very close and hence all lines are not visible: with ART prevention effect, ART effect on HIV transmission probability 1/2 of that observed in HPTN 052, and ART effect on HIV transmission probability 1/2 of that observed in HPTN 052.</p

“Crowding out”: Number of new infections per year in South Africa if a fixed number of HRHA are diverted from ART to TasP.

<p>“Crowding out”: Number of new infections per year in South Africa if a fixed number of HRHA are diverted from ART to TasP.</p

Deaths among HIV-infected people with and without ART resistance (in the absence of second-line ART).

<p>Deaths among HIV-infected people with and without ART resistance (in the absence of second-line ART).</p

Example scenario for distribution of available HRHA across HIV stages in the model, reflecting an 80/20 distribution of patients on ART/TasP, i.e., 80% of treated patients on ART (CD4 cell count ≤350 μl) and 20% on TasP (CD4 cell count >350 μl).

<p>Example scenario for distribution of available HRHA across HIV stages in the model, reflecting an 80/20 distribution of patients on ART/TasP, i.e., 80% of treated patients on ART (CD4 cell count ≤350 μl) and 20% on TasP (CD4 cell count >350 μl).</p

New infections with and without ART resistance (in the absence of second-line ART).

<p>New infections with and without ART resistance (in the absence of second-line ART).</p

“Surge capacity”: The number of HRHA needed after reaching universal (100%) ART coverage.

<p>The Fig shows the drawdown in HRHA that is possible while maintaining universal ART coverage for two cases: if ART has no prevention effects and if ART has prevention effects.</p

The HIV infections model.

<p>New 15-year-old HIV-uninfected individuals flow into the HIV-uninfected pools (1). HIV-uninfected individuals participate in sexual activity with HIV-uninfected and HIV-infected individuals (2), giving rise to new HIV infections (3), which together with new HIV-infected 15-year-olds (4) add to the HIV-infected pool. HIV-infected people progress through different stages of HIV infection (5) until reaching CD4 cell count < 200μl (6) (purple color indicates people receiving ART).</p

Previous results from (5) showing ART coverage would decline if human resources for delivering ART remained constant.

<p>Results are shown for sub-Saharan Africa (SSA), non–sub-Saharan Africa (NSSA), and South Africa (SA). Year 0 is 2007.</p

ART coverage in the presence of high levels of outmigration of HRHA.

<p>ART coverage in the presence of high levels of outmigration of HRHA.</p