1. Implementation of 'Treat‐all' at adult HIV care and treatment sites in the Global IeDEA Consortium: results from the Site Assessment Survey
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Brazier, Ellen, Maruri, Fernanda, Duda, Stephany N., Tymejczyk, Olga, Wester, C William, Somi, Geoffrey, Ross, Jeremy, Freeman, Aimee, Cornell, Morna, Poda, Armel, Musick, Beverly S., Zhang, Fujie, Althoff, Keri N., Mugglin, Catrina, Kimmel, April D., Yotebieng, Marcel, Nash, Denis, Karminia, Azar, Sohn, Annette H., Allen, Debbie, Bloch, Mark, Boyd, Susan, Brown, Katherine, Costa, Jess, Donohue, William, Gunathilake, Manoji, Hoy, Jennifer, Macrae, Karen, Moore, Richard, Roth, Norman, Rowling, Diane, Silvers, Julie, Smith, David J., Sowden, David, Templeton, David, Varma, Rick, Woolley, Ian, Youds, David, Meng, Somanithd Chhay, Vannary, Bun, Chan, Yun Ting, Lam, Wilson, Lee, Man Po, Ning, Han, Pansy, Yu Po Chu, Kumarasamy, N., Pujari, Sanjay, Kurniati, Nia, Merati, Tuti Parwati, Muktiarti, Dina, Parwata, Wayan Sandhi, Ratni, Made, Sukmawati, Ni Made Dewi Dian, Vedaswari, Dian Sulistya Putu Diah, Wati, Ketut Dewi Kumara, Yunihastuty, Evy, Tanuma, Junko, Mills, Graham, Raymond, Nigel, Ditangco, Rossana, Papa, Ohnmar Seinn, Tek, Ng Oon, Azwa, Raja, Daud, Fauziah, Juin, Wong Ke, Kamarulzaman, Adeeba Binti, Khairulddin, Nik, Li, Chong Meng, Moy, Fong Siew, Shah, Raja Iskandar, Shyan, Wong Peng, Sim, Benedict, Thahira, Jamal Mohamed, Tuang, Koh Mia, Yusoff, Nik, Choi, Jun Yong, Chan, Yu?Jiun, Huang, Chih?Sheng, Wing?Wai, Wong, Avihingsanon, Anchalee, Chokephaibulkit, Kulkanya, Hansudewechakul, Rawiwan, Khumcha, Benjhawan, Khusuwan, Suwimon, Kiertiburanakul, Sasisopin, Lumbiganon, Pagakrong, Maleesatharn, Alan, Praparattanapan, Jutarat, Puthanakit, Thanyawee, Sricharoenchai, Sirintip, Sudjaritruk, Tavitiya, Watanaporn, Suporn, An, Vu Thien, Cuong, Do Duy, H?ng, Bùi Thu, Huy, Bùi V?, Quy, Du Tuan, Van, Lam Nguyen, Baragunzwa, Agathomfue, Gakima, Dévote, Ingabire, Gloria, Kankinoi, Floride, Manyundo, Risase Scholastique, Misago, Celestin, Nahimana, Thierry, Nimbona, Pélagie, Ntirampeba, Felicite, Twizere, Christella, Ajeh, Rogers, Djenabou, Amadou, Dzudie, Anastase, Ewanoge, Alice Ndelle, Tchassem, Edmond, Bampapa, Therese, Lelo, Patricia, Kitetele, Faustin, Paul, Marie, Tytyna, Amida, Akolbout, Maryse, Bitsindou, Parfait, Diafouka, Merlin, Mafoua, Adolphe, Mahinga, Nadine, Moudila, Ella, Moutoula, Antoinette, Ndala, Ulrich, Nsonde, Dominique Mahambou, Ayinkamiye, Josephine, Dusabe, Chantal, Hakizimana, Theogene, Mbaraga, Gilbert, Mukamana, Joyce, Mukantwali, Sandrine, Munyaneza, Athanase, Murangwa, Anthere, Musenguwera, J. Claude, Ngutegure, Marie Immanculee, Ntarambirwa, Fidele, Nyiransabimana, Diane, Sinayobye, Jean D'Amour, Tuyishimire, Yvonne, Uwamahoro, Olive, Viateur, Habumuremyi, Vincent, Sugira, Kuhn, Yee Yee, Musick, Beverly, Rodriguez, Israel, Wools?Kaloustian, Kara, Yiannoutsos, Constantin, Akajoroit, Esinasi, Ariya, Peter, Atsimale, Meshack, Barua, Zeruya, Busaka, Oscar, Bukusi, Elizabeth, Chebor, Valentine, Chemweno, Timothy, Chirchir, John, Esendi, Lameck Diero Sagida, Fwamba, Aisha, Mmella, Anne, Githumbi, Eunice, Hussein, Marcia Nasimiyu, Kandie, Xavier, Kemunto, Martha, Khaemba, Elizabeth, Kipchumba, Mary, Koech, Emily, Kosgei, Caroline, Laundrick, Barasa, Merongo, Ruth, Mochotto, Patricia, Munyisi, Consolata, Ndakalu, Lilian, Ochieng, William Okoth, Odalo, Paul, Okumu, Wicklife, Omari, Lilian, Omondi, Alphoce, Osia, Lydia, Owino, Magret, Oyoo, Maureen, Pepela, Doris, Rono, Millicent, Simon, Omar, Tenge, Angie, Too, Mary, Toto, Modesta, Towett, Cathrine, Wawire, Kennedy, Kimambo, Mensaria, Kinyota, Ester, Lyamuya, Rita, Mathias, Julia, Mfuko, Athuman Ramadhan, Michael, Denna, Ngonyani, Kapella Zacharia, Nyaga, Charles, Somi, G.R., Urassa, Mark S., Batte, James, Bwana, Mwebesa Bosco, Castelnuovo, Barbara, Kanyesigye, Michael, Kisakye, Alice, Nalugoda, Fred, Semuwemba, Haruna, Ssali, John, Ssemakadde, Matthew, Castilho, Jessica, Cesar, Carina, De Alencastro, Paulo Ricardo, Barbosa, Eduardo Luiz, Brites, Carlos, Caricol, Renata, Carmo, Fabiana Bononi Do, Coelho, Lara Esteves, Escuder, Maria Mercedes, Estevam, Denize Lotufo, Ferreira, Flavia Gomes Faleiro, Gonçalves, Alexandre, Gouvêa, Aída Barbosa, Ikeda, Maria Leticia Rodrigues, Kalichman, Artur O., Machado, Daisy Maria, Queiroz, Simone, Souza, Rosa, Succi, Regina Célia, Trindade, Kátia Valeska, Tupinambás, Unai, Wolff, Marcelo, Rouzier, Vanessa, Padgett, Denis, Crabtree, Brenda, Martin, Carlos Eduardo Verne, Mejia, Fernando, Chang, Benny, Done, Brenda, Gabe, Larry, Gill, John, Gough, Kevin, Howlett, Gail, Klein, Marin, Latendre?Paquette, Judy, Leung, Victor, Macphee, Paul, Macpherson, P., Maharaj, Raj, Medina, Lorna Carrasco, Page, Suzanne, Pexos, Costas, Rachlis, Anita, Salters, Kate, Sterling, Sherine, Boswell, Stephen, Burkholder, Greer, Cesteros, Gisela, Chagaris, Kalliope, Franklin, Rosa, Fuhrer, Jack, Gilbert, Cynthia L., Goetz, Matthew, Grasso, Chris, Horberg, Michael, Hunter?Mellado, Robert F., Kell, Rita, Kitahata, Mari, Klein, Daniel, Levine, Ken, Marconi, Vincent, Mathews, Christopher, Mayor, Angel M., Mcgowan, Catherine, Napravnik, Sonia, Novak, Richard, Oursler, Kris Ann, Ramos, Shellier, Rodriguez, Benigno, Rodriguez, Maria C., Silverberg, Michael, Simberkoff, Michael S., Varshney, Mohit, Ward, Douglas, Widick, Barb, Yangco, Bienvenido G., Davies, Mary?Ann, Smith, Lilian, Von Groote, Per Maximilian, Muhairwe, Josephine, Balakasi, Steve, Banda, Quietus, Kalepa, Getrude, Bello, Andrew, Bulla, J.W., Chigeda, Maria, Chikaphupha, Joyce, Chikwekwere, Flora, Kachoka, Jack, Kapito, Allan, Katondo, Alinafe Nathan, Kumwenda, Molly, Labein, Felix Phewa, Magombo, Ronald, Malumbe, Bridget, Makuwira, I., Marico, Patricia, Masangale, Betha, Mchiela, Angella, Midian, Dan, Phiri, Kezia, Tambe, Mary, Thomas, Baid, Thomson, Charles, Hector, Jonas, Cross, Anna, Dlamini, Siphephelo, Eley, Brian, Euvrard, Jonathan, Fatti, Geoffrey, Hilderbrand, Katherine, Hsiao, Marvin, Mpye, Michael, Prozesky, Hans, Reubenson, Gary, Rose, Lesley, Sawry, Shobna, Sibambo, Nosisa, Technau, Karl, Vinikoor, Michael, Chimbetete, Cleophas, Kamenova, Kamelia, Balestre, Eric, Leroy, Valeriane, Malasteste, Karen, Djimon, Marcel Zannou, D' Almeida, Marcelline, Hounhoui, Ghislaine, Assogba, Michee, Zoungrana, Jacques, Yaméogo, Issouf, Tapsoba, Achille, Abdelh, Sidibé, Bosse, Clarisse Amani, Diabaté, Mamoudou, Eboua, Tanoh Kassi François, Folquet, Madeleine Amorissani, Hawelander, Denise, Konaté, Mamadou, Kouakou, Kouadio, Lambert, Dohoun, Minga, Albert Kla, N'Gbeche, Marie Sylvie, Tanon, Aristophane, Yao, Abo, Renner, Lorna, N'Diaye, Clémentine, Berthé, Mme Alima, Seydi, Moussa, Tine, Judicaël, Elom, Takassi Ounoo, Kariylare, Benjamin, and Patassi, Akessiwe
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Public health administration -- Evaluation ,HIV infection -- Diagnosis -- Drug therapy ,Health - Abstract
: Introduction: Since 2015, the World Health Organization (WHO) has recommended that all people living with HIV (PLHIV) initiate antiretroviral treatment (ART), irrespective of CD4+ count or clinical stage. National adoption of universal treatment has accelerated since WHO's 2015 “Treat All” recommendation; however, little is known about the translation of this guidance into practice. This study aimed to assess the status of Treat All implementation across regions, countries, and levels of the health care delivery system. Methods: Between June and December 2017, 201/221 (91%) adult HIV treatment sites that participate in the global IeDEA research consortium completed a survey on capacity and practices related to HIV care. Located in 41 countries across seven geographic regions, sites provided information on the status and timing of site‐level introduction of Treat All, as well as site‐level practices related to ART initiation. Results: Almost all sites (93%) reported that they had begun implementing Treat All, and there were no statistically significant differences in site‐level Treat All introduction by health facility type, urban/rural location, sector (public/private) or country income level. The median time between national policy adoption and site‐level introduction was one month. In countries where Treat All was not yet adopted in national guidelines, 69% of sites reported initiating all patients on ART, regardless of clinical criteria, and these sites had been implementing Treat All for a median period of seven months at the time of the survey. The majority of sites (77%) reported typically initiating patients on ART within 14 days of confirming diagnosis, with 60% to 62% of sites implementing Treat All in East, Southern and West Africa reporting same‐day ART initiation for most patients. Conclusions: By mid‐ to late‐2017, the Treat All strategy was the standard of care at almost all IeDEA sites, including rural, primary‐level health facilities in low‐resource settings. While further assessments of site‐level capacity to provide high‐quality HIV care under Treat All and to support sustained viral suppression after ART initiation are needed, the widespread introduction of Treat All at the service delivery level is a critical step towards global targets for ending the HIV epidemic as a public health threat., Introduction WHO's 2015 recommendation for immediate treatment of all PLHIV, regardless of CD4+ cell count, represented a paradigm shift in HIV care and treatment. By preventing morbidity and mortality among [...]
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- 2019
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