Media Releases

Zambart, UNZA and University of Toronto researchers find health systems must evolve to meet long-term needs of people living longer on ART

December 8, 2015

TORONTO, ON — Mil­lions of peo­ple with HIV in Sub-Saha­ran Africa are liv­ing longer lives due to anti­retro­vi­ral ther­a­py (ART). For many, ART is trans­form­ing HIV into a chron­ic ill­ness. Peo­ple are there­fore like­ly to have new needs relat­ed to liv­ing longer with HIV. But lit­tle is known about the expe­ri­ences of grow­ing up and grow­ing old­er with HIV in coun­tries like Zam­bia, where the focus has been on HIV test­ing and start­ing treat­ment.

Today, researchers at Zam­bart, the Uni­ver­si­ty of Zam­bia and their part­ners in Cana­da and South Africa have released find­ings of the three-year Sepo II Study, which offer new insight into the ups and downs of life on ART.

“Sepo II find­ings point to short­com­ings in the cur­rent mod­el of HIV care in Zam­bia that focus­es on ini­ti­at­ing and adher­ing to ART. These health ser­vices are nec­es­sary but not suf­fi­cient for meet­ing the new needs of peo­ple liv­ing longer as a result of ART,” said Dr. Stephanie Nixon, co-lead of the Sepo II Study and Direc­tor of the Inter­na­tion­al Cen­tre for Dis­abil­i­ty and Reha­bil­i­ta­tion at the Uni­ver­si­ty of Toron­to (ICDR, “HIV pol­i­cy and pro­grams also need to address the health- and life-relat­ed impacts of liv­ing longer with HIV such as coun­sel­ing for issues beyond VCT and adher­ence, and reha­bil­i­ta­tion to pro­mote func­tion and qual­i­ty of life.”

The Sepo II Study explored the expe­ri­ences of women and men liv­ing with HIV and on ART in Lusa­ka, Zam­bia to bet­ter under­stand their dai­ly func­tion­ing, hopes and chal­lenges over the course of three points in time.

“Our data from the Sepo II Study pro­mote the evo­lu­tion of Zambia’s HIV care con­tin­u­um to embrace a long-term approach to liv­ing well with chron­ic HIV, “said Dr. Vir­ginia Bond, Sepo II Study co-lead and Senior Researcher at Zam­bart. “We also need to real­ize that despite treat­ment, stig­ma per­sists for peo­ple liv­ing long-term with HIV and we need to revamp efforts to address and reduce HIV stig­ma.”

The Chawa­ma Lev­el 1 Hos­pi­tal and Lusa­ka Trust Hos­pi­tal were piv­otal part­ners, help­ing to both imple­ment the study and inter­pret results. But it is the 35 women and men who gave so gen­er­ous­ly of their time and shared their per­son­al sto­ries who deserve cred­it for the suc­cess of the Sepo II Study.

“We know more than we did before about the rela­tion­ship chal­lenges that peo­ple nav­i­gate as part of liv­ing their lives on ART,” said Dr. Mar­garet Maim­bol­wa, Senior Lec­tur­er in the Uni­ver­si­ty of Zam­bia School of Med­i­cine. “ARVs will sus­tain peo­ple and they can expect to live longer, but what prepa­ra­tions are we mak­ing to sup­port peo­ple liv­ing with HIV for 10, 20, 30 years?”

Sepo II Study results build on last week’s focus on “dif­fer­en­ti­at­ed care” at the Inter­na­tion­al Con­fer­ence on AIDS and STIs in Africa (ICASA), which requires that each patient liv­ing with HIV is treat­ed as an indi­vid­ual with unique needs.

“The Sepo II Study gives us new areas to explore,” said Dr. Anitha Menon, Senior Lec­tur­er in the Uni­ver­si­ty of Zam­bia Depart­ment of Psy­chol­o­gy. “We learned about the impor­tance of self-accep­tance as a strat­e­gy for stay­ing healthy, as well as the chal­lenges relat­ed to healthy sex­u­al­i­ty.”

Study find­ings extend pre­vi­ous research on HIV and episod­ic dis­abil­i­ty con­duct­ed in Cana­da. Notably, this is the first study in Africa to describe episod­ic dis­abil­i­ty.

Part­ners on the Sepo II Study team include the Cana­di­an Work­ing Group on HIV and Reha­bil­i­ta­tion (, the Health Eco­nom­ics and HIV/AIDS Research Divi­sion (HEARD) at the Uni­ver­si­ty of KwaZu­lu-Natal, the Dis­abil­i­ty HIV&AIDS Trust (DHAT), McMas­ter Uni­ver­si­ty, and Uni­ver­si­ties With­out Walls in Cana­da.

This study was fund­ed by the Cana­di­an Insti­tutes of Health Research (CIHR).

For more infor­ma­tion about the web­site, please vis­it Uni­ver­si­ty of Toronto’s Sepo II Study web­site (‑2).



Dr. Vir­ginia Bond
Zam­bart and Lon­don School of Hygiene and Trop­i­cal Med­i­cine
Lusa­ka, Zam­bia
+260 211 254 710
Dr. Stephanie Nixon
Depart­ment of Temer­ty Temer­ty Fac­ul­ty of Med­i­cine, Depart­ment of Phys­i­cal Ther­a­py Dal­la Lana School of Pub­lic Health Inter­na­tion­al Cen­tre for Dis­abil­i­ty and Reha­bil­i­ta­tion Uni­ver­si­ty of Toron­to Toron­to, Cana­da