Gender distribution of adult patients on highly active antiretroviral therapy (HAART) in Southern Africa: a systematic review

Background: HIV and AIDS are significant and growing public health concerns in southern Africa. The majority of countries in the region have national adult HIV prevalence estimates exceeding 10 percent. The increasing availability of highly active antiretroviral therapy (HAART) has potential to mitigate the situation. There is however concern that women may experience more barriers in accessing treatment programs than men. Methods: A systematic review of the literature was carried out to describe the gender distribution of patients accessing highly active antiretroviral therapy (HAART) in Southern Africa. Data on number of patients on treatment, their mean or median age and gender were obtained and compared across studies and reports. Results: The median or mean age of patients in the studies ranged from 33 to 39 years. While female to male HIV infection prevalence ratios in the southern African countries ranged from 1.2:1 to 1.6:1, female to male ratios on HAART ranged from 0.8: 1 to 2.3: 1. The majority of the reports had female: male ratio in treatment exceeding 1.6. Overall, there were more females on HAART than there were males and this was not solely explained by the higher HIV prevalence among females compared to males. Conclusion: In most Southern African countries, proportionally more females are on HIV antiretroviral treatment than men, even when the higher HIV infection prevalence in females is accounted for. There is need to identify the factors that are facilitating women's accessibility to HIV treatment. As more patients access HAART in the region, it will be important to continue assessing the gender distribution of patients on HAART.Peer Reviewe

Challenges of data availability : Analysing the water-energy nexus in electricity generation

Water is paramount for the operation of energy systems, for securing food supply and for the industry and municipalities. Intersectoral competition for water resources can negatively affect water scarce regions by e.g. power plants shutdowns, poor agricultural yields, and lack of potable water. Future economic and population growth as well as climate change is likely to exacerbate these patterns. However, models used for energy system management and planning in general do not properly include water availability which can lead to improper representations of water-energy interlinkages. The paper initially highlights the water usage rates of current technologies within electricity generation and technologies with a potential to reduce water usage, electricity consumption or GHG emissions. Secondly, the paper presents currently available data on current and future projected water resources as well as data on energy statistics relevant to water-energy nexus studies. Thirdly, implementation cases are presented showing examples of water-energy nexus studies for the data presented. Finally, the paper highlights main challenges in studying the linkage between water and energy. We find a substantial gap in the general availability and quality of regional and global data for detailed quantitative analyses and also identify a need for standardization of formats and data collection methodologies across data and disciplines. An effort towards a coordinated, and sustained open-access data framework with energy sector water usage at fine spatio-temporal scales alongside hydroclimatic observation and model data using common forcings and scenarios for future projections (of climate, socio-economy and technology) is therefore recommended for future water-energy nexus studies.</p