title: Scale-up and continuation of antiretroviral therapy in South African treatment programs, 2005-2009.
abstract: BACKGROUND
  South Africa has the greatest burden of HIV-infection in the world with about 5.2 million HIV-infected adults. In 2003, the South African Government launched a comprehensive HIV and AIDS care treatment program supported by the United States in 2004 through the President's Emergency Plan for AIDS Relief (PEPFAR).
  
  
  METHODS
  To describe the scale-up and continuation of antiretroviral therapy in South African Government and PEPFAR-supported sites in South Africa, we conducted a retrospective analysis of routinely collected program reporting data, 2005-2009.
  
  
  RESULTS
  From 2005 through 2009, the average rate of persons initiated on antiretroviral therapy in PEPFAR-supported South African Government treatment programs increased nearly four-fold from 6,327 a month in 2005-2006 to 24,622 a month in 2008-2009 resulting in an increase from 33,543 patients on continued treatment in April-June 2005 to 631,985 patients in July-September 2009. Of those 631,985 patients receiving treatment, 65% were women. Men were more likely to be lost to follow-up (9.2% vs. 7.8%, PR 1.18, 95% CI 1.17-1.19) and more likely to die (5.6% vs. 4.1%, PR 1.36, 95% CI 1.35-1.37) than women.
  
  
  CONCLUSIONS
  Scale-up and continuation of antiretroviral therapy in South Africa has been a remarkable medical accomplishment. Because more women receive and continue treatment, more efforts are needed to treat and retain men.
authors.affiliation: Centers for Disease Control and Prevention, Global AIDS Program, Atlanta, Georgia, USA. klausnerj@sa.cdc.gov
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
authors.forename: Celicia
authors.initials: C
authors.lastname: Serenata
authors.forename: Heidi
authors.initials: H
authors.lastname: O'Bra
authors.forename: Christine L
authors.initials: CL
authors.lastname: Mattson
authors.forename: J W
authors.initials: JW
authors.lastname: Brown
authors.forename: Melinda
authors.initials: M
authors.lastname: Wilson
authors.forename: Thobile
authors.initials: T
authors.lastname: Mbengashe
authors.forename: Thurma M
authors.initials: TM
authors.lastname: Goldman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013019:South Africa; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents