ArticleTherapeutics and clinical risk management2020
HIV Treatment Outcomes Among Patients Initiated on Antiretroviral Therapy Pre and Post-Universal Test and Treat Guidelines in South Africa.
Article in Therapeutics and clinical risk management, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 4 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Characterisation of HIV-1 Gag Cytotoxic T-Lymphocyte Epitopes in the Southern African Region-A Systematic Review.Immunology · 2026Pooled it
- Systematic review and meta-analysis of retention and disengagement after initiation on antiretroviral therapy in low- and middle-income countries after the introduction of Universal Test and Treat policies.Journal of the International AIDS Society · 2025Pooled it
- Attrition one year after starting antiretroviral therapy before and after the programmatic implementation of HIV "Treat All" in Sub-Saharan Africa: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- Men missing from the HIV care continuum in sub-Saharan Africa: a meta-analysis and meta-synthesis.Journal of the International AIDS Society · 2022Pooled it
- Trial
- HIV testing and linkage to ART following secondary distribution of HIV self-test kits to male partners of women living with HIV: a pilot randomized control trial in Mpumalanga, South Africa.Journal of the International AIDS Society · 2022Trial
- Postpartum continuity of care for women with HIV: Option B+ policy impact and limitations in South Africa.BMJ global health · 2026Article
- Time to treatment failure and its predictors among children attending antiretroviral therapy in Jimma, southwest Ethiopia: a retrospective cohort study.BMC pediatrics · 2026Article
- Why Are They Leaving? Factors Associated With Attrition After Testing Among Young South Africans Recently Diagnosed With HIV: An Observational Study.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2025Observational
- Enhancing Antiretroviral Therapy Initiation for Hospitalized and Recently Discharged People Living With HIV in Johannesburg, South Africa.Global health, science and practice · 2025Article
- Prevalence and factors associated with HIV viral rebound in individuals on ART: A systematic review study.Journal of public health in Africa · 2025Review
- Peripartum mobility and maternal/child separation among women living with HIV in South Africa.AIDS care · 2024Article
- Linkage to HIV care and early retention in HIV care among men in the 'universal test-and-treat' era in a high HIV-burdened district, KwaZulu-Natal, South Africa.BMC health services research · 2024Observational
- Long-term HIV care outcomes under universal HIV treatment guidelines: A retrospective cohort study in 25 countries.PLoS medicine · 2024Article
- Changes in access to viral load testing, incidence rates of viral load suppression and rebound following the introduction of the 'universal test and treat' guidelines in Cameroon: A retrospective follow-up analysis.PLOS global public health · 2024Article
- Immunologic, virologic and drug resistance outcomes in an HIV-infected prospective cohort on treatment in South Africa.PloS one · 2024Observational
- Enhancing linkage to HIV care in the "Universal Test and Treat" era: Barriers and enablers to HIV care among adults in a high HIV burdened district in KwaZulu-Natal, South Africa.BMC public health · 2023Article
- The impact of same-day antiretroviral therapy initiation on retention in care and clinical outcomes at four eThekwini clinics, KwaZulu-Natal, South Africa.BMC health services research · 2023Article
- Opioid use and HIV treatment services experiences among male criminal justice-involved persons in South Africa: a qualitative study.Harm reduction journal · 2023Article
- Human Immunodeficiency Virus Viral Load Monitoring and Rate of Virologic Suppression Among Patients Receiving Antiretroviral Therapy in Democratic Republic of the Congo, 2013-2020.Open forum infectious diseases · 2023Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionOfficially rolled out on 01 September 2016, South Africa's Universal Test and Treat (UTT) policy calls for first-line antiretroviral treatment (ART) initiation among all known HIV-positive patients, irrespective of CD4 cell count. We evaluate treatment outcomes of patients initiated on first-line ART directly before and after the implementation of UTT.
methodsWe analysed prospectively collected clinical cohort data among ART-naïve adult patients within two HIV clinics in Johannesburg, South Africa. We compare two groups: 1) an unexposed pre-UTT group initiating treatment from 01 December 2014 to 31 May 2015; and 2) an exposed UTT group initiating treatment from 01 December 2016 to 31 May 2017. Primary treatment outcomes included lost to follow-up (LTFU) (>90 days late for the last scheduled visit with no subsequent clinical visit). Cox proportional hazards models were used to estimate the association between pre-UTT vs UTT initiation on LTFU by 12 months.
resultsWe included 2410 patients. A total of 1267 (52.6%) patients initiated ART before UTT implementation and 1143 (47.4%) after the change in policy. LTFU (adjusted Hazard Ratio (aHR): 1.51; 95% Confidence Interval (CI): 1.16-1.98) between groups and specifically among those initiating with a CD4 cell count ≤500 cells/mm
conclusionLTFU under UTT proved higher than that of previous periods. Patients initiating first-line therapy under the treat-all policy may often start treatment in better health, subsequently not perceiving a direct benefit to treatment which may deter patients from consistent engagement in HIV treatment programmes.
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