Leickness Simbayi

• M.Sc., D.Phil.
• Deputy CEO for Research at Human Sciences Research Council (HSRC)

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) exhibit escape from pre-existing immunity and elicit variant-specific immune responses. In South Africa, the second wave of SARS-CoV-2 infections was driven by the Beta VOC, which coincided with the country-wide National COVID-19 Antibody Survey (NCAS). The NCAS...

Background Early detection and initiation of care is crucial to the survival and long-term well-being of children living with HIV (CLHIV). However, there remain challenges regarding early testing and linking of CLHIV for early treatment. This study examines the progress made towards achieving the 95-95-95 HIV indicators and associated factors among...

Background: Despite the increased initiation and uptake of antiretroviral therapy (ART) in South Africa, some people living with HIV (PLHIV) who are on ART still have non-suppressed viral load (VL). Objectives: This study aimed to determine the prevalence of VL non-suppression among adolescents and youth (aged 12 years – 24 years) living with HIV...

External HIV-related stigma remains pervasive, and its effect debilitating among PLHIV in South Africa, even though the country has made many advances against HIV. External HIV-related stigma impedes both HIV prevention and access to health care and reduces the quality of treatment and care received. This study examined the prevalence of and factor...

Introduction There is growing recognition that adolescent boys and young men (ABYM) have been left behind in the HIV response and are under-represented in HIV services, leading to poor outcomes across the HIV care cascade. Improved understanding of the HIV epidemic in this population is important for engaging ABYM in the HIV response. This study ex...

Background Early detection and initiation in care is crucial to the survival and long-term well-being of children living with HIV. However, there remain challenges regarding early testing and linking of infants and children who are positive for early treatment. This study examines the HIV treatment indicators and associated factors among children y...

Introduction In South Africa, current epidemic control efforts include strategies to reach all young people and leave no one behind. Hence there is a need to track HIV among adolescent boys and young men (ABYM) to support these efforts. We examined HIV prevalence and associated factors among ABYM aged 15-24 years using the 2017 South African Nation...

Population-based serological testing is important to understand the epidemiology and estimate the true cumulative incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to inform public health interventions. This study reports findings of a national household population SARS-CoV-2 serosurvey in people 12 years and older in South...

Background: Despite high HIV prevalence in transgender women in sub-Saharan Africa, to our knowledge no study presents data across the HIV care continuum for this population in the region. The aim of this study was to estimate HIV prevalence and present data to develop the HIV care continuum indicators for transgender women in three South African...

As South Africa and the rest of the world adjust to living with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), review and analysis of data on SARS-CoV-2 infections is needed to inform policy decisions for ongoing best outcomes. Drawing from South Africa’s first national population-based household SARS-CoV-2 sero-prevalence survey...

South Africa is one of the countries on the African continent that was most affected by the COVID-19 pandemic. Sero-prevalence surveys of SARS-CoV-2 antibodies provide valuable information about the extent of the pandemic given the existence of asymptomatic cases. Here report findings of a nationwide household-based population survey of SARS-CoV-2...

Background Psychological distress as measured by mental disorders like depression and anxiety is more prevalent in people living with HIV (PLHIV) than in the general population. However, the relationship between mental disorders and HIV is complex and bidirectional. Improved understanding of the relationship between mental disorders and HIV is impo...

This report presents results from the latest South African Stigma Index 2.0 which was aimed at measuring levels of stigma and discrimination experienced by PLHIV in 6 selected districts. The study investigated the stigma and discrimination experienced by PLHIV. We explored the intersection of HIV related stigma with TB, COVID-19, disability, SOGI,...

South Africa has the largest number of people living with HIV worldwide. South Africa has implemented five population-based HIV prevalence surveys since 2002 aimed at understanding the dynamics and the trends of the epidemic. This paper presents key findings from the fifth HIV prevalence, incidence, and behaviour survey conducted in 2017 following...

In this paper, risk compensation among individuals on antiretroviral therapy (ART), using the 2017 South African national survey on HIV, is explored. A multi-stage stratified cluster random sampling approach was used to realize 11,130 participants 15 years and older. Logistic regression analysis assessed the association between multiple sexual part...

This paper assesses the levels of antiretroviral treatment (ART) adherence and mental health distress among study participants in a national behavioural HIV-sero prevalence study South Africa. The study was a cross-sectional population-based multi-stage stratified cluster random survey, (SABSSM V, 2017). Structured questionnaires were used to colle...

In this paper we present results from the first national house-hold based SARS CoV- 2 sero-prevalence survey conducted in South Africa in 2020-21. The survey used a cross-sectional multi-stage stratified cluster design. The data was collected over two separate time periods (November 2020 - February 2021 and April - June 2021). This periods coincide...

BACKGROUND: South Africa is one of the African countries most affected by the COVID-19 pandemic. SARS-CoV-2 sero-prevalence surveys provide valuable epidemiological information given the existence of asymptomatic cases. We report the findings of the first nationwide household-based population estimates of SARS-CoV-2 sero-prevalence among people age...

We investigated HIV prevalence and associated factors among men ≥ 15 years in South Africa using data from a 2017 nationwide cross-sectional survey. HIV prevalence was 10.5% among 6 646 participants. Prevalence increased from 4.1% in the younger men (15–24 years), 12.5% in young men (25–34 years) to 12.7% in older men (≥ 35 years). Odds of being in...

Background: Mental disorders like depression and anxiety are more prevalent in people living with HIV (PLHIV) than in the general population. Improved understanding of the relationship between mental disorders and HIV is important for designing interventions for this group. However, the relationship between mental disorders and HIV is complex and b...

South Africa has a high infectious disease burden with overlapping Human Immunodeficiency Virus (HIV) and tuberculosis (TB) epidemics. People living with HIV (PLHIV) are vulnerable to drug-resistant TB, and HIV is associated with multi- and extremely-drug resistant TB epidemics and outbreaks. South Africa has conducted population-based national HI...

Disclosure in the context of HIV is the sharing of information about one’s HIV-positive status, and many factors influence the decision to do so. This study examined the prevalence and predictors of HIV disclosure to adult family members using data collected from the South African 2014 People Living with HIV (PLHIV) Stigma Index. A purposive sample...

Background: Identification of the geographical areas with low uptake of HIV testing could assist in spatial targeting of interventions to improve the uptake of HIV testing. Objectives: The objective of this research study was to map the uptake of HIV testing at the district level in South Africa. Method: The secondary analysis used data from the Hu...

Background: Improved understanding of barriers to HIV testing is important for reaching the first of the UNAIDS 90-90-90 targets, which states that 90% of HIV positive individuals ought to know their HIV status. This study examined socio-economic status (SES) differences in HIV testing uptake and associated factors among youth and adults 15 years...

Sexual identity stigma is associated with negative outcomes including increased HIV/STI risk and suicidality. This study used the HIV Stigma Framework to guide the development of a Multidimensional Sexual Identity Stigma (MSIS) scale. A refined sexual identity stigma scale was tested with 292 men who have sex with men (MSM) in Port Elizabeth (n = 1...

Abstract Background The first 90 of UNAIDS 90–90–90 targets to have 90% of the people living with HIV know their status is an important entry point to the HIV treatment cascade and care continuum, but evidence shows that there is a large gap between males and females in this regard. It is therefore important to understand barriers and facilitators...

Background HIV related stigma and psychological distress among people living with HIV (PLHIV) pose a public health challenge in most African countries. This study aims to investigate the association between HIV related stigmatizing attitudes and psychological distress amongst PLHIV in South Africa using the 2012 nationally representative population...

Background In South Africa, age-disparate to sexual relationships where the age difference between partners is 5 years or greater is an important contributor to the spread of HIV. However, little is known about the predictors of age-disparate sexual relationships. This study investigates factors associated with age-disparate sexual relationships am...

Background: The first 90 of UNAIDS 90–90–90 targets to have 90% of the people living with HIV know their status is an important entry point to the HIV treatment cascade and care continuum, but evidence shows that there is a large gap between males and females in this regard. It is therefore important to understand barriers and facilitators of achie...

Background: Improved understanding of barriers to HIV testing is important for reaching the first of the UNAIDS 90-90-90 targets, which states that 90 percent of HIV positive individuals ought to know their HIV status. This study examined socioeconomic status (SES) factors and related covariates associated with HIV testing uptake in the general pop...

Abstract Background Measuring progress towards the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90–90–90 treatment targets is key to assessing progress towards turning the HIV epidemic tide. In 2017, the UNAIDS model estimated that 75% of people living with HIV (PLHIV) globally knew their HIV positive status, 79% of those who knew their stat...

Current communication messages in the COVID-19 pandemic tend to focus more on individual risks than community risks resulting from existing inequities. Culture is central to an effective community-engaged public health communication to reduce collective risks. In this commentary, we discuss the importance of culture in unpacking messages that may b...

Background HIV testing contributes to the prevention and control of the HIV epidemic in the general population. South Africa has made strides to improve HIV testing towards reaching the first of the UNAIDS 90–90–90 targets by 2020. However, to date no nationally representative analysis has examined temporal trends and factors associated with HIV te...

This report provides the most comprehensive national scale data on MSM in Ghana that then can be used to inform evidence-based programming targeted at a known population with tailored services reducing new HIV infections and improving the care and treatment for MSM. I am confident that the data is comprehensive to providing the information necessar...

Background: The intersection of violence exposure and mental health problems is a public health crisis for South African (SA) adolescents. Understanding the impact of community violence on adolescent mental health can inform future interventions. Objectives: To assess pathways between community violence exposure and internalising and externalisi...

Background: South Africa has implemented variations of second generation surveillance surveys to monitor human immunodeficiency virus (HIV) epidemic. Objective : This paper compares HIV estimates from two design variations, namely the take all approach and sub-sampling approach to ascertain if any changes in HIV epidemic are due to methodological...

Psychological distress symptoms like depression and anxiety are potentially dangerous conditions in HIV positive individuals influencing health-seeking behaviour, care and treatment leading to poor health outcomes. This study sought to determine the prevalence of psychological distress symptoms and associated socio-demographic and health-related fa...

Stigma is a well-documented barrier to health seeking behavior, engagement in care and adherence to treatment across a range of health conditions globally. In order to halt the stigmatization process and mitigate the harmful consequences of health-related stigma (i.e. stigma associated with health conditions), it is critical to have an explicit the...

Background: In South Africa, persistence of the HIV epidemic and associated gender and racial disparities is a major concern after more than 20 years of democratic dispensation and efforts to create a more healthy and equal society. This paper profiles HIV prevalence and related factors among Black African men and women compared to other race group...

Background: The prevalence and effect of polygamous relationships may have serious reproductive and /or health consequences for women. In South Africa, unlike in other sub-Saharan countries, no nationwide survey has investigated polygamy except for the 2002 HIV/AIDS population-based household survey. The aim of this study was to profile socio-demo...

Abstract Background South Africa is making tremendous progress in the fight against HIV, however, adolescent girls and young women aged 15–24 years (AGYW) remain at higher risk of new HIV infections. This paper investigates socio-demographic and behavioural determinants of HIV infection among AGYW in South Africa. Methods A secondary data analysis...

Introduction: Correct knowledge of HIV transmission and prevention and myth rejection is a prerequisite to practicing safer behavior and important for reducing the risk of new infections. This study investigates the association between correct knowledge of HIV transmission, prevention and myth rejection with socio-demographic factors and HIV-relate...

The poster presents results that describe the personal, social and structural contexts that frame HIV risk for ‘black’ South African women (20-34 years old), ‘black’ South African men (25-49 years old) and young ‘black’ South African women aged 15-24 years old.

Background: In South Africa, there are limited nationally representative data on the prevalence and factors associated with psychological distress. This study used a 2012 nationally representative population-based household survey to investigate factors associated with psychological distress in South Africa. Methods: The survey is based on a multis...

The present study investigated the associations among alcohol use, socioeconomic status (SES), and human immunodeficiency virus (HIV) status, in the South African context. It was hypothesized that SES (predictor; measured as median split asset score) and alcohol use in the past 12 months (predictor) would interact such that current drinkers of low...

The provision of good quality education in public sector schools in South Africa is intrinsically linked to the health, wellbeing and productivity of educators employed in this sector. The National Department of Basic Education (DBE) commissioned the Human Sciences Research Council (HSRC) to conduct a second national survey to assess the health and...

Provides an introduction to this special edition of Psychological Trauma. The papers included in this special section focus on aspects of trauma and the effects of trauma in a cultural context that pertains to the way of life in South Africa. These articles highlight the complexities of the effects of trauma and call for tailored interventions to a...

Objectives: In Sub-Saharan African countries, including South Africa, uptake of human immunodeficiency virus (HIV) testing among men remains a major challenge. Few studies have explored HIV testing uptake among men and factors that influence their testing behaviours. This article explores trends in HIV testing uptake and associated factors among m...

This paper explores the prevalence and correlates of HIV seropositive status disclosure to sexual partners by people living with HIV (PLHIV) in South Africa. Secondary analysis of the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey was conducted on data obtained from 934 sexually active PLHIV aged 15 years and older who r...

Objective: Using daily diary methods, we aimed to test the hypothesis that at the event-level consuming alcohol increases the likelihood that antiretrovirals (ARV) will be missed on a particular day. Methods: This prospective cohort study of 74 (52 female, 22 male) people living with HIV (PLHIV) in South Africa collected event-level data on ARV...

Background In South Africa, voluntary medical male circumcision (VMMC) has recently been implemented as a strategy for reducing the risk of heterosexual HIV acquisition among men. However, there is some concern that VMMC may lead to low risk perception and more risky sexual behavior. This study investigated HIV risk perception and risk behaviors am...

Background: The HIV epidemic in South Africa is characterized mainly by heterosexual transmission. Recently, the importance of targeting key populations and marginalized groups, including men who have sex with men (MSM) and transgender people, has been added to the national agenda. Objectives: This mini-review explores the current state of empir...

Introduction: HIV positive people are the main source of new infections, which occur mainly through risk behaviours with a high-risk partner. Awareness of HIV status has been proposed as a key factor underlying sexual and HIV risk behaviour. This study sought to determine whether awareness of one’s HIV positive status translates to reduced sexual r...

This article presents key findings from the 2012 HIV prevalence, incidence and behaviour survey conducted in South Africa and explores trends in the HIV epidemic. A representative household based survey collected behavioural and biomedical data among people of all ages. Chi-squared test for association and formal trend tests (2002, 2005, 2008 and 2...

Background: South Africa is one of the 22 high tuberculosis burden countries that contribute 80% of the global tuberculosis cases. Tuberculosis is infectious and due to its rapid and easy transmission route poses a threat to population health. Considering the importance of social and psychological factors in influencing health outcomes, appraising...

Globally intimate partner violence (IPV) is a public health problem that can be perpetrated by both males and females, although males are more likely to inflict severe IPV-related injuries on their female partners. In low- and middle-income countries like South Africa, few studies have conducted research to determine whether IPV perpetration by men...

Sexual risk behaviors place either of the sexual partners involved at increased risk of some negative health outcomes such as increasing the chance of acquiring or transmitting disease especially sexually transmitted infections including human immunodeficiency virus or having an unwanted pregnancy. They include early sexual debut, unsafe sexual pra...

Literature from sub-Saharan Africa and elsewhere supports a global association between alcohol and HIV risk. However, more rigorous studies using multiple event-level methods find mixed support for this association, suggesting the importance of examining potential moderators of this relationship. The present study explores the assumptions of alcoho...

The sexual behavior of individuals living with HIV determines the onward transmission of HIV. With the understanding that antiretroviral therapy (ART) prevents transmission of HIV, the sexual behaviors of the individuals not on ART with unsuppressed viral loads becomes of the greatest importance in elucidating transmission. We assessed the associat...

High risk sexual behaviour, alcohol and drug use, and mental health problems combine to yield high levels of HIV-risk behaviour among adolescents with mental health problems. In South Africa, little research has been conducted on parental perspectives of HIV-risk among this population. We conducted a series of focus group discussions with 28 mother...

The study, called the Marang2 Men’s Project, was implemented among MSM in the three largest cities of South Africa: Cape Town in the Western Cape, Durban in KwaZulu-Natal and Johannesburg in Gauteng. The primary objectives of this study were to achieve the following: • Provide baseline data on HIV prevalence among MSM in each of the three cities. •...

This study explored South African adolescents’ perceived risk and protection for HIV infection. Adolescents (N = 28) with a mean age of 14.6 years receiving mental health care participated in Focus Group Discussions (FGDs) to engage in an in-depth exploration of their perceived risk and protective mechanisms for HIV prevention. The data were analys...

Non-communicable diseases (NCDs) represent a leading threat to human health and development. Globally, NCD deaths are projected to increase by 17% over the next 10 years, with the greatest increase to be seen in the African region (27%). South Africa is undergoing an epidemiological transition from communicable diseases to NCDs, and recent reliable...

Theory-based sexual risk reduction interventions are often demonstrated effective, but few studies have examined the mechanisms that mediate their behavior changes. In addition, critical contextual factors, such as alcohol use, are often not accounted for by social cognitive theories and may add to the explanatory value of intervention effects. The...

Background: The objectives of the current national study were to determine the rates of self-reported circumcision among South African men and, more importantly, evaluate the acceptability of male circumcision in South Africa by uncircumcised adult men and all adult women. Materials and methods: The study based on a population-based survey inclu...

Abstract HIV counselling and testing (HCT) is considered important because it is an entry point to a comprehensive continuum of care for HIV/AIDS. The South African Department of Health launched an HCT campaign in April 2010, and this reached 13,269,746 people by June 2011, of which 16% tested HIV positive and 400,000 of those were initiated into a...

To the Editor: Once again the nation is outraged by the now familiar annual tale of how a number of initiates undergoing traditional male circum cision in several provinces have paid with permanent disability, or the ultimate penalty of death, for taking part in cultural practices that have outlived their value in today's South Africa. While we res...

South Africa is known to have particularly high levels of intimate partner violence (IPV) against women. This study aims to examine the association between men's hostile sexist attitudes toward women and men's self-report perpetration of IPV. This study was a retrospective cross-sectional survey. A total of 829 men, aged 18 years or older, were rec...

South African townships have among the highest rates of HIV infection in the world. Considerable research on understanding the high rates of HIV transmission in this country has identified alcohol use as a critical factor in driving the HIV epidemic. Although the relationship between alcohol use and sexual risk-taking is well documented, less is kn...

Little research has investigated interventions to improve the delivery of counselling in health care settings. We determined the impact of training and supervision delivered as part of the Options: Western Cape project on lay antiretroviral adherence counsellors' practice. Four NGOs employing 39 adherence counsellors in the Western Cape were random...

Condom use has increased significantly over the past decade among all adult age groups in South Africa, and it is widely believed to have played a major role in the recent significant decline in HIV incidence in the country, especially among young people. This study investigated the demographic, behavioural and psychosocial correlates of condom use...

South Africa is known to have particularly high levels of intimate partner violence (IPV) against women. This study aims to examine the association between men's hostile sexist attitudes toward women and men's self-report perpetration of IPV. This study was a retrospective cross-sectional survey. A total of 829 men, aged 18 years or older, were rec...

The first part of this chapter provides an account of the history of HIV and AIDS in South Africa through a review of the literature. The next section outlines the epidemiology of HIV in South Africa, using the results from the four repeated surveys conducted by the HSRC and its partners in 2002, 2005, 2008 and 2012 to determine trends and to demon...

HIV testing benefits those who test positive, allowing them to receive treatment, but the benefits for those who test negative remain controversial. We evaluated the impact of testing on HIV knowledge and sexual risk among men in South Africa. Men were recruited from townships outside Cape Town and completed a survey that assessed testing history,...

South African alcohol-serving establishments (i.e., shebeens) offer unique opportunities to reduce HIV risks among men who drink. Purpose: To test an individual- and a social structural-level HIV prevention intervention for men who drink in shebeens. Twelve matched pairs of township neighbourhoods were randomized to receive either (i) an HIV preven...

Objective: Options for Health is an evidence-based sexual risk reduction intervention based on motivational interviewing (MI). Thirty-nine antiretroviral adherence lay counselors were trained to deliver Options for Health to help their patients to optimize their antiretroviral treatment adherence. An evaluation of counselors' ability to deliver th...

Male condoms remain a key tool in preventing the spread of HIV and the female condom (FC) holds similar potential. Using data collected through a national cross-sectional population survey that was conducted in 2008, this report investigated the national prevalence of FC knowledge and use by sexually active males and females (n = 7,727) over the ag...

In the Western Cape, lay counsellors are tasked with supporting antiretroviral (ARV) adherence in public healthcare clinics. Thirty-nine counsellors in 21 Cape Town clinics were trained in Options for Health (Options), an evidence-based intervention based on motivational interviewing (MI). We evaluated counsellors' ability to deliver Options for ad...

South African townships have high HIV prevalence and a strong need for collective action to change normative sexual risk behaviors. This study investigated the relationship between perceptions of individuals about collective efficacy in the community's ability to prevent HIV and their personal HIV risk behaviors. Men (n = 1,581) and women (n = 718)...

The first cases of AIDS in the Republic of South Africa were diagnosed primarily in young men who had sex with men. Although HIV has spread heterosexually from neighboring countries and established a generalized HIV/AIDS epidemic, men who have sex with men (MSM) remain according to recent evidence a significant population affected by AIDS in South...