ArticleInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases2023
Increasing the initiation of antiretroviral therapy through optimal placement of diagnostic technologies for pediatric HIV in Zimbabwe: A modeling analysis.
Article in International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Baseline Data on Viral Suppression, Treatment Adherence and Mental Health in Peripartum Girls and Young Women With HIV in Zimbabwe.Journal of the International AIDS Society · 2026Observational
- Optimizing the location of point-of-care infant HIV testing devices in Zimbabwe to maximize impact and value: A modeling analysis.PloS one · 2026Article
- Optimising HIV drug resistance testing laboratory networks in Kenya: insights from systems engineering modelling.BMJ open · 2024Article
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Authors and funding
11 authors.
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Abstract
objectivesPoint-of-care (POC) devices for infant HIV testing provide timely result-return and increase antiretroviral (ART) initiation. We aimed to optimally locate POC devices to increase 30-day ART initiation in Matabeleland South, Zimbabwe.
methodsWe developed an optimization model to identify the locations for limited POC devices at health facilities, maximizing the number of infants who receive HIV test results and initiate ART within 30 days of testing. We compared location-optimization model results to non-model-based decision heuristics, which are more practical and less data-intensive. Heuristics assign POC devices based on demand, test positivity, laboratory result-return probability, and POC machine functionality.
resultsWith the current placement of 11 existing POC machines, 37% of all tested infants with HIV were projected to receive results and 35% were projected to initiate ART within 30 days of testing. With optimal placement of existing machines, 46% were projected to receive results and 44% to initiate ART within 30 days, retaining three machines in current locations, moving eight to new facilities. Relocation based on the highest POC device functionality would be the best-performing heuristic decision (44% receiving results and 42% initiating ART withing 30 days); although, it still would not perform as well as the optimization-based approach.
conclusionOptimal and ad hoc heuristic relocation of limited POC machines would increase timely result-return and ART initiation, without further, often costly, interventions. Location optimization can enhance decision-making regarding the placement of medical technologies for HIV care.
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