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

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.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.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.There is increasing global interest to ensure that HIV infected persons have access to antiretroviral therapy. In the developed world, mortality from AIDS has significantly reduced, in part due to wide availability and accessibility to highly active antiretroviral therapy (HAART). In resource-limited countries however, although there has been steady progress in increasing accessibility to antiretroviral therapy (ART), most patients have no access to this life saving intervention [1]. Natrass suggests that the poor and vulnerable segments of society are likely to miss out from accessing HAART. In many societies, women are likely to be poor and socially vulnerable.When patients in resource limited settings access HAART, treatment adherence has been reported to be comparable