ArticleJournal of the International AIDS Society2020
Decreasing time to antiretroviral therapy initiation after HIV diagnosis in a clinic-based observational cohort study in four African countries.
Article in Journal of the International AIDS Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 29 citations in OpenAlex.
- Trial
- A retrospective analysis of maternal factors, access of prevention of vertical transmission resources, and infant preterm delivery and mortality.AIDS (London, England) · 2026Article
- Temporal trends in tuberculosis and time from enrolment in care to antiretroviral therapy initiation: A multicountry cohort study from Latin America.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2025Article
- HIV Infection in Portugal: Measuring the Time Between Linkage to Care and Antiretroviral Therapy Initiation.Healthcare (Basel, Switzerland) · 2025Article
- Impact of increasing CD4 count threshold eligibility for antiretroviral therapy initiation on advanced HIV disease and tuberculosis prevalence and incidence in South Africa: an interrupted time series analysis.BMJ global health · 2025Article
- Temporal trends from HIV diagnosis to ART initiation among adults living with HIV in the Asia-Pacific (2013-2023).AIDS research and therapy · 2025Observational
- The Transformative Impact of the African Cohort Study (AFRICOS) Toward Reaching HIV 95-95-95 Goals in Sub-Saharan Africa.The American journal of tropical medicine and hygiene · 2025Article
- Cohort Profile: The Zurich Primary HIV Infection Study.Microorganisms · 2024Article
- Retrospective analysis of CD4 count trends in South Africa.Southern African journal of HIV medicine · 2024Article
- Probabilistic HIV recency classification-a logistic regression without labeled individual level training data.The annals of applied statistics · 2023Article
- Long-term outcomes of rapid antiretroviral NNRTI-based initiation among Thai youth living with HIV: a national registry database study.Journal of the International AIDS Society · 2023Article
- Temporal Trends of Clinical Characteristics and Treatments in People Living with HIV at the Initiation of Antiretroviral Therapy - Beijing Municipality, China, 2010-2020.China CDC weekly · 2023Article
- Predictors of All-Cause Mortality Among People With Human Immunodeficiency Virus (HIV) in a Prospective Cohort Study in East Africa and Nigeria.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Factors associated with testing for HIV and other sexually transmitted infections in men who have sex with men and transgender women in Bangkok, Thailand.AIDS research and therapy · 2022Article
- Clinical factors and outcomes associated with immune non-response among virally suppressed adults with HIV from Africa and the United States.Scientific reports · 2022Article
- Clinical similarities and differences between two large HIV cohorts in the United States and Africa.PloS one · 2022Observational
- Transient Reductions in Human Immunodeficiency Virus (HIV) Clinic Attendance and Food Security During the Coronavirus Disease 2019 (COVID-19) Pandemic for People Living With HIV in 4 African Countries.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Persons living with HIV in sero-discordant partnerships experience improved HIV care engagement compared with persons living with HIV in sero-concordant partnerships: a cross-sectional analysis of four African countries.AIDS research and therapy · 2021Article
- Attaining 95-95-95 through Implementation Science: 15 Years of Insights and Best Practices from the Walter Reed Army Institute of Research's Implementation of the U.S. President's Emergency Plan for AIDS Relief.The American journal of tropical medicine and hygiene · 2021Article
- Decreasing time to antiretroviral therapy initiation after HIV diagnosis in a clinic-based observational cohort study in four African countries.Journal of the International AIDS Society · 2020Article
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 3 countries.
Funding
Abstract
introductionWorld Health Organization (WHO) guidelines have shifted over time to recommend earlier initiation of antiretroviral therapy (ART) and now encourage ART initiation on the day of HIV diagnosis, if possible. However, barriers to ART access may delay initiation in resource-limited settings. We characterized temporal trends and other factors influencing the interval between HIV diagnosis and ART initiation among participants enrolled in a clinic-based cohort across four African countries.
methodsThe African Cohort Study enrols adults engaged in care at 12 sites in Uganda, Kenya, Tanzania and Nigeria. Participants provide a medical history, complete a physical examination and undergo laboratory assessments every six months. Participants with recorded dates of HIV diagnosis were categorized by WHO guideline era (<2006, 2006 to 2009, 2010 to 2012, 2013 to 2015, ≥2016) at the time of diagnosis. Cox proportional hazard modelling was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI) for time to ART initiation. RESULTS AND DISCUSSION: From January 2013 to September 2019, a total of 2888 adults living with HIV enrolled with known diagnosis dates. Median time to ART initiation decreased from 22.0 months (interquartile range (IQR) 4.0 to 77.3) among participants diagnosed prior to 2006 to 0.5 months (IQR 0.2 to 1.8) among those diagnosed in 2016 and later. Comparing those same periods, CD4 nadir increased from a median of 166 cells/mm
conclusionsConsistent with changing guidelines, the interval between diagnosis and ART initiation has decreased over time. Still, many adults living with HIV initiated treatment with low CD4, highlighting the need to diagnose HIV earlier while improving access to immediate ART after diagnosis.
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