Trial reportBMJ open2020
Impact of the test and treat policy on delays in antiretroviral therapy initiation among adult HIV positive patients from six clinics in Johannesburg, South Africa: results from a prospective cohort study.
Trial report in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- 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
- Prevalence of delayed antiretroviral therapy initiation among people living with HIV: A systematic review and meta-analysis.PloS one · 2023Pooled it
- A community mobilisation intervention to improve engagement in HIV testing, linkage to care, and retention in care in South Africa: a cluster-randomised controlled trial.The lancet. HIV · 2022Trial
- Point-of-care CD4 testing: Differentiated care for the most vulnerable.Journal of global health · 2022Trial
- Retention in care and viral suppression after same-day ART initiation: One-year outcomes of the SLATE I and II individually randomized clinical trials in South Africa.Journal of the International AIDS Society · 2021Trial
- Beyond knowledge deficits: social visibility, family dynamics, and delayed initiation among people living with HIV in Southwestern China-a descriptive phenomenological study.BMC public health · 2026Article
- Retention and predictors of loss-to-follow-up among patients on antiretroviral therapy in the Test-and-Treat Era: evidence from a retrospective cohort study in Maputo, Mozambique.BMC infectious diseases · 2026Article
- Prevalence and factors associated with HIV drug resistance among adult persons living with HIV/AIDS in nine countries of Sub-Saharan Africa using population-based HIV impact assessments: 2015-2019.BMC public health · 2025Article
- Initiation of Dolutegravir Versus Efavirenz on Viral Suppression and Retention at 6 months: A Regression Discontinuity Design.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- The impact of a comprehensive strategy on HIV treatment continuum in a highly endemic area of China: an interrupted time series analysis.BMC infectious diseases · 2025Article
- Article
- Improving patient-centred counselling skills among lay healthcare workers in South Africa using the Thusa-Thuso motivational interviewing training and support program.PLOS global public health · 2024Article
- Immediate and long-term outcomes after treat-all among people living with HIV in China: an interrupted time series analysis.Infectious diseases of poverty · 2023Article
- Article
- Article
- Healthcare provider perceptions on the implementation of the universal test-and-treat policy in South Africa: a qualitative inquiry.BMC health services research · 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
- Same-Day ART Initiation and Associated Factors Among People Living with HIV on Lifelong Therapy at Nekemte Specialized Hospital, Western Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Perceptions toward antiretroviral therapy and delayed ART initiation among people living with HIV in Changsha, China: mediating effects of treatment willingness.Frontiers in public health · 2023Article
- Evolution of prevention of mother to child transmission of HIV policy in Zambia: Application of the policy triangle to understand the roles of actors, process and power.Global public health · 2022Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivesTo assess delays to antiretroviral therapy (ART) initiation before and after the Universal Test and Treat (UTT) and the same-day initiation (SDI) of ART policy periods in Johannesburg, South Africa.
designProspective cohort study.
settingPatients were recruited from six primary health clinics in Johannesburg.
participantsOverall, 1029 newly diagnosed HIV positive adults (≥18 years) were consecutively enrolled by referral from the testing counsellor between April and December 2015 (pre-UTT n=146), July and August 2017 (UTT, n=141) and October 2017 and August 2018 (SDI, n=742).
main outcome measuresCox proportional hazards regression was used to assess predictors of 30 days ART initiation. Additionally, predictors of immediate ART initiation were evaluated using Poisson regression.
resultsOverall, 30 days ART proportions were 71.9% overall, 36.9% pre-UTT (44.3% of those eligible), 65.9% under UTT and 79.9% under the SDI policy. The median days to ART initiation declined from 21 pre-UTT (IQR: 15-30) to 8 (IQR: 6-16) under UTT and 5 days (IQR: 0-8) under the SDI policy. However, only 150 (20.2%) of the SDI cohort-initiated ART immediately after HIV diagnosis. Living in a two-adult home (adjusted HR (aHR) 1.2 vs living alone, 95% CI 1.0 to 1.5) increased the likelihood of 30-day ART. Missing baseline cluster of differentiation four (CD4) data decreased the likelihood of 30 days ART by 40% (aHR 0.6 vs CD4 <350 cells/µL, 95% CI 0.5 to 0.7). More women took up immediate ART (adjusted relative risk (aRR) 1.3, 95% CI 1.0 to 1.9). Participants ≥40 years (aRR 0.6 vs 18-24 years, 95% CI 0.4 to 0.9) were less likely to start ART immediately after HIV diagnosis. However, immediate ART rates increased with longer policy implementation time (aRR 0.2 for <3 months vs >10 months, 95% CI 0.1 to 0.4).
conclusionsThe study results highlight a positive move towards earlier ART initiation during the UTT and SDI periods and emphasise a need to increase same-day ART implementation further.
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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.