Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
SEARCH Human Immunodeficiency Virus (HIV) Streamlined Treatment Intervention Reduces Mortality at a Population Level in Men With Low CD4 Counts.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01864603 (Sustainable East Africa Research in Community Health), which is not on this map. Cited by 15 papers, 1 of them a synthesis 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.
Sustainable East Africa Research in Community Health
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Person-centred interventions to improve patient-provider relationships for HIV services in low- and middle-income countries: a systematic review.Journal of the International AIDS Society · 2024Pooled it
- Community-Wide Universal HIV Test and Treat Intervention Reduces Tuberculosis Transmission in Rural Uganda: A Cluster-Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Trial
- Projected outcomes of universal testing and treatment in a generalised HIV epidemic in Zambia and South Africa (the HPTN 071 [PopART] trial): a modelling study.The lancet. HIV · 2022Trial
- Effect of a patient-centered hypertension delivery strategy on all-cause mortality: Secondary analysis of SEARCH, a community-randomized trial in rural Kenya and Uganda.PLoS medicine · 2021Trial
- Time to Antiretroviral Therapy Initiation After HIV Diagnosis in the Integrase Strand Transfer Inhibitor Era - Nanjing City, Jiangsu Province, China, 2021-2024.China CDC weekly · 2026Article
- Expert consensus on the clinical management of HIV late presentation.Infectious diseases & immunity · 2026Article
- Peer network approaches for improving HIV testing, prevention and care utilisation among men in sub-Saharan Africa: a scoping review.BMJ open · 2026Article
- The association between rapid antiretroviral therapy initiation and brain structure and function based on multimodal magnetic resonance imaging in HIV-positive men who have sex with men.BMC infectious diseases · 2025Article
- Survival of People Living with HIV/AIDS from Pre-ART Era to Treat-all Era - China, 1985-2022.China CDC weekly · 2024Article
- The impact of primary health care on AIDS incidence and mortality: A cohort study of 3.4 million Brazilians.PLoS medicine · 2024Article
- The effect of primary health care on AIDS incidence and mortality: a cohort study of 3.4 million Brazilians.medRxiv : the preprint server for health sciences · 2023Article
- Rapid start antiretroviral therapies for improved engagement in HIV care: implementation science evaluation protocol.BMC health services research · 2023Article
- Article
- What do the Universal Test and Treat trials tell us about the path to HIV epidemic control?Journal of the International AIDS Society · 2020Article
- Reaching 90-90-90 in rural communities in East Africa: lessons from the Sustainable East Africa Research in Community Health Trial.Current opinion in HIV and AIDS · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundWe tested the hypothesis that patient-centered, streamlined human immunodeficiency virus (HIV) care would achieve lower mortality than the standard treatment model for persons with HIV and CD4 ≤ 350/uL in the setting of population-wide HIV testing.
methodsIn the SEARCH (Sustainable East Africa Research in Community Health) Study (NCT01864603), 32 communities in rural Uganda and Kenya were randomized to country-guided antiretroviral therapy (ART) versus streamlined ART care that included rapid ART start, visit spacing, flexible clinic hours, and welcoming environment. We assessed persons with HIV and CD4 ≤ 350/uL, ART eligible in both arms, and estimated the effect of streamlined care on ART initiation and mortality at 3 years. Comparisons between study arms used a cluster-level analysis with survival estimates from Kaplan-Meier; estimates of ART start among ART-naive persons treated death as a competing risk.
resultsAmong 13 266 adults with HIV, 2973 (22.4%) had CD4 ≤ 350/uL. Of these, 33% were new diagnoses, and 10% were diagnosed but ART-naive. Men with HIV were almost twice as likely as women with HIV to have CD4 ≤ 350/uL and be untreated (15% vs 8%, respectively). Streamlined care reduced mortality by 28% versus control (risk ratio [RR] = 0.72; 95% confidence interval [CI]: .56, .93; P = .02). Despite eligibility in both arms, persons with CD4 ≤ 350/uL started ART faster under streamlined care versus control (76% vs 43% by 12 months, respectively; P < .001). Mortality was reduced substantially more among men (RR = 0.61; 95% CI: .43, .86; P = .01) than among women (RR = 0.90; 95% CI: .62, 1.32; P = .58).
conclusionsAfter population-based HIV testing, streamlined care reduced population-level mortality among persons with HIV and CD4 ≤ 350/uL, particularly among men. Streamlined HIV care models may play a key role in global efforts to reduce AIDS deaths.
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