Evidence map›Paper›PMID 28770595›Full record

Observational studyJournal of the International AIDS Society2017

High rates of retention and viral suppression in the scale-up of antiretroviral therapy adherence clubs in Cape Town, South Africa.

Priscilla Ruvimbo Tsondai, Lynne Susan Wilkinson, Anna Grimsrud, Precious Thembekile Mdlalo, Angelica Ullauri, Andrew Boulle

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of the International AIDS Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
89citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

89 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  17. Differentiated antiretroviral distribution: Implementation in five South African districts.African journal of primary health care & family medicine · 2025
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  20. International journal of MCH and AIDS · 2025
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29 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Priscilla Ruvimbo TsondaiSchool of Public Health and Family Medicine, University Of Cape Town, Cape Town, South Africa.
Lynne Susan WilkinsonSchool of Public Health and Family Medicine, University Of Cape Town, Cape Town, South Africa.
Anna GrimsrudInternational AIDS Society, Cape Town, Khayelitsha, South Africa.
Precious Thembekile MdlaloSchool of Public Health and Family Medicine, University Of Cape Town, Cape Town, South Africa.
Angelica UllauriSchool of Public Health and Family Medicine, University Of Cape Town, Cape Town, South Africa.
Andrew BoulleSchool of Public Health and Family Medicine, University Of Cape Town, Cape Town, South Africa.

Funding

Bill and Melinda Gates Foundation
6 · The paper itself

Abstract

introductionIncreasingly, there is a need for health authority scale up of successfully piloted differentiated models of antiretroviral therapy (ART) delivery. However, there is a paucity of evidence on system-wide outcomes after scale-up. In the Cape Town health district, stable adult patients were referred to adherence clubs (ACs) - a group model of ART delivery with five visits per year. By the end of March 2015, over 32,000 ART patients were in an AC. We describe patient outcomes of a representative sample of AC patients during this scale-up.

methodsPatients enrolled in an AC at non-research supported sites between 2011 and 2014 were eligible for analysis. We sampled 10% of ACs (

resultsOf the 3216 adults contributing 4019 person years of follow-up (89% in an AC, median 1.1 years), 70% were women. Retention was 95.2% (95% CI, 94.0-96.4) at 12 months and 89.3% (95% CI, 87.1-91.4) at 24 months after AC enrolment. In the 13 months prior to analysis closure, 88.1% of patients had viral load assessments and of those, viral loads ≤400 copies/mL were found in 97.2% (95% CI, 96.5-97.8) of patients. Risk of LTFU was higher in younger patients and in patients accessing ART from facilities with larger ART cohorts. Risk of viral rebound was higher in younger patients, those that had been on ART for longer and patients that had never sent a buddy to collect their medication.

conclusionsThis is the first analysis reporting patient outcomes after health authorities scaled-up a differentiated care model across a high burden district. The findings provide substantial reassurance that stable patients on long-term ART can safely be offered care options, which are more convenient to patients and less burdensome to services.

Indexed as

Medication AdherenceViral LoadAdolescentAdultAnti-HIV AgentsCohort StudiesCross-Sectional StudiesFemaleHIV InfectionsHumansMaleMiddle AgedProportional Hazards ModelsRetrospective StudiesSouth AfricaYoung AdultAnti-HIV Agentsadherence clubantiretroviral therapyHIVmodels of careprogram outcomesretention

Identifiers

PMID28770595
PMCPMC5577696

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.