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2. Prevalence and risk of burnout among HIV service providers in South Africa and Zambia: findings from the HPTN 071 (PopART) trial

Author

Steinhaus, Mara C., Nicholson, Tamaryn J., Pliakas, Triantafyllos, Harper, Abigail, Lilleston, Pamela, Mainga, Tila, Milimo, Deborah, Jennings, Karen, Grobbelaar, Nelis, Louis, Francoise, Liebenberg, Handri, Hayes, Richard J., Fidler, Sarah, Ayles, Helen, Bock, Peter, Hoddinott, Graeme, Hargreaves, James R., Bond, Virginia, and Stangl, Anne L.

Published
2024
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3. Associations between HIV stigma and health-related quality-of-life among people living with HIV: cross-sectional analysis of data from HPTN 071 (PopART)

Author

Hall, Emily, Davis, Katherine, Ohrnberger, Julius, Pickles, Michael, Gregson, Simon, Thomas, Ranjeeta, Hargreaves, James R., Pliakas, Triantafyllos, Bwalya, Justin, Dunbar, Rory, Mainga, Tila, Shanaube, Kwame, Hoddinott, Graeme, Bond, Virginia, Bock, Peter, Ayles, Helen, Stangl, Anne L., Donnell, Deborah, Hayes, Richard, Fidler, Sarah, and Hauck, Katharina

Published
2024
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4. The impact of an innovative community-based peer-led intervention on uptake and coverage of sexual and reproductive health services among adolescents and young people 15–24 years old: results from the Yathu Yathu cluster randomised trial

Author

Phiri, Mwelwa Muleba, Schaap, Albertus, Hensen, Bernadette, Sigande, Lucheka, Simuyaba, Melvin, Mwenge, Lawrence, Zulu-Phiri, Rosemary, Mwape, Louis, Floyd, Sian, Fidler, Sarah, Hayes, Richard, Simwinga, Musonda, and Ayles, Helen

Published
2024
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9. Impact of interrupting antiretroviral therapy started during primary HIV-1 infection on plasma neurofilament light chain protein, a marker of neuronal injury: The SPARTAC trial

Author

Alagaratnam, Jasmini, Stöhr, Wolfgang, Hamlyn, Elizabeth, Porter, Kholoud, Toombs, Jamie, Heslegrave, Amanda, Zetterberg, Henrik, Gisslén, Magnus, Underwood, Jonathan, Schechter, Mauro, Kaleebu, Pontiano, Tambussi, Giuseppe, Kinloch, Sabine, Miro, Jose M., Kelleher, Anthony D., Babiker, Abdel, Frater, John, Winston, Alan, and Fidler, Sarah

Published
2024
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10. Long-term efficacy and safety of a treatment strategy for HIV infection using protease inhibitor monotherapy: 8-year routine clinical care follow-up from a randomised, controlled, open-label pragmatic trial (PIVOT)

Author

Fisher, Martin, Clarke, Amanda, Hadley, Wendy, Stacey, David, Johnson, Margaret, Byrne, Pat, Williams, Ian, De Esteban, Nahum, Pellegrino, Pierre, Haddow, Lewis, Arenas-Pinto, Alejandro, Orkin, Chloe, Hand, James, De Souza, Carl, Murthen, Lisa, Crawford-Jones, Andrew, Chen, Fabian, Wilson, Ruth, Green, Elizabeth, Masterson, John, Lee, Vincent, Patel, Kamlesh, Howe, Rebecca, Winston, Alan, Mullaney, Scott, Gompels, Mark, Jennings, Louise, Beeching, Nicholas, Tamaklo, Rebecca, Fox, Julie, Teague, Alistair, Jendrulek, Isabelle, Tiraboschi, Juan Manuel, Wilkins, Ed, Clowes, Yvonne, Thompson, Andrew, Brook, Gary, Trivedi, Manoj, Aderogba, Kazeem, Jones, Martin, DeBurgh-Thomas, Andrew, Jones, Liz, Reeves, Iain, Mguni, Sifiso, Chadwick, David, Spence, Pauline, Nkhoma, Nellie, Warwick, Zoe, Price, Suzanne, Read, Sally, Herieka, Elbushra, Walker, James, Woodward, Ruth, Day, John, Hilton, Laura, Harinda, Veerakathy, Blackman, Helen, Hay, Phillip, Mejewska, Wendy, Okolo, Olanike, Ong, Edmund, Martin, Karen, Munro, Lee, Dockrell, David, Smart, Lynne, Ainsworth, Jonathan, Waters, Anele, Kegg, Stephen, McNamara, Sara, Taylor, Steve, Gilleran, Gerry, Gazzard, Brian, Rowlands, Jane, Allan, Sris, Sandhu, Rumun, O'Farrell, Nigel, Quaid, Sheena, Martin, Fabiola, Bennett, Caroline, Kapembwa, Moses, Minton, Jane, Calderwood, James, Post, Frank, Campbell, Lucy, Wandolo, Emily, Palfreeman, Adrian, Mashonganyika, Linda, Balachandran, Thambiah, Kakowa, Memory, O'Connell, Rebecca, Tanawa, Cheryl, Jebakumar, Sinna, Hagger, Lesley, Quah, Say, McKernan, Sinead, Lacey, Charles, Douglas, Sarah, Russell-Sharpe, Sarah, Brewer, Christine, Leen, Clifford, Morris, Sheila, Obeyesekera, Sharmin, Williams, Shirley, David, Nelson, Roberts, Mark, Wollaston, Julie, Paton, Nicholas, Stöhr, Wolfgang, Scott, Karen, Dunn, David, Beaumont, Emma, Fleck, Sue, Hall, Mark, Hennings, Susie, Kummeling, Ischa, Martins, Sara, Owen-Powell, Ellen, Sanders, Karen, van Hooff, Fionna, Vivas, Livia, White, Ellen, Angus, Brian, Freedman, Andrew, Cromerty, Ben, Mercey, Danielle, Fidler, Sarah, Torok, Estee, Babiker, Abdel, Peto, Tim, Lalloo, David, Phillips, Andrew, James, Robert, Paton, Nicholas I., and Dunn, David T.

Published
2024
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11. Demographics of sources of HIV-1 transmission in Zambia: a molecular epidemiology analysis in the HPTN 071 PopART study

Author

Agyei, Yaw, Beyers, Nulda, Bock, Peter, Bond, Virginia, Bwalya, Justin, Cori, Anne, Deventer, Anneen, Dunbar, Rory, El-Sadr, Wafaa, Emel, Lynda, Floyd, Sian, Griffith, Sam, Hargreaves, James, Hauck, Katharina, Headen, Tanette, Hoddinott, Graeme, James, Anelet, Jennings, Karen, Kanema, Sarah, Kosloff, Barry, Kruger, James, Kumar, Ramya, Macleod, David, Makola, Nozizwe, Mandla, Nomtha, Miller, Eric, Moore, Ayana, Mwenge, Lawrence, Noble, Heather, Phiri, Mwelwa, Pickles, Michael, Sabapathy, Kalpana, Sakala, Ephraim, Sauter, Rafael, Shanaube, Kwame, Silumesi, Andrew, Sista, Nirupama, Skalland, Tim, Smith, Peter, Thomas, Ranjeeta, Vermund, Sten, White, Rhonda, Wilson, Ethan, Yang, Blia, Yuhas, Krista, Bowden, Rory, Calvez, Vincent, Essex, Max, Grabowski, Kate, Gupta, Ravindra, Herbeck, Joshua, Kagaayi, Joseph, Kaleebu, Pontiano, Lingappa, Jairam, Moyo, Sikhulile, Novitsky, Vladimir, Ndung’u, Thumbi, Pillay, Deenan, Quinn, Thomas, Rambaut, Andrew, Seeley, Janet, Ssemwanga, Deogratius, Tanser, Frank, Wawer, Maria, Hall, Matthew, Golubchik, Tanya, Bonsall, David, Abeler-Dörner, Lucie, Limbada, Mohammed, Schaap, Ab, de Cesare, Mariateresa, MacIntyre-Cockett, George, Otecko, Newton, Probert, William, Ratmann, Oliver, Bulas Cruz, Ana, Piwowar-Manning, Estelle, Burns, David N, Cohen, Myron S, Donnell, Deborah J, Eshleman, Susan H, Simwinga, Musonda, Fidler, Sarah, Hayes, Richard, Ayles, Helen, and Fraser, Christophe

Published
2024
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19. The effect of universal testing and treatment for HIV on health-related quality of life – An analysis of data from the HPTN 071 (PopART) cluster randomised trial

Author

Davis, Katherine, Pickles, Michael, Gregson, Simon, Hargreaves, James R., Ayles, Helen, Bock, Peter, Pliakas, Triantafyllos, Thomas, Ranjeeta, Ohrnberger, Julius, Bwalya, Justin, Bell-Mandla, Nomtha, Shanaube, Kwame, Probert, William, Hoddinott, Graeme, Bond, Virginia, Hayes, Richard, Fidler, Sarah, and Hauck, Katharina

Published
2023
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21. Use of point-of-care C-reactive protein testing for screening of tuberculosis in the community in high-burden settings: a prospective, cross-sectional study in Zambia and South Africa

Author

Africa, Algernon, Amofa-Skeyi, Modupe, Bond, Virginia, Cheeba, Maina, Dodd, Pete, Kalisvaart, Nico, Kangololo, Bxyn, Kasese, Nkatya, Mainga, Tila, Mwinga, Alwyn, Nikolayevskyy, Vladyslav, Nyondo, Beatrice, Paulsen, Robynn, Simwinga, Musonda, Sisam, Carmen, Telisinghe, Lily, Thomas, Ranjeeta, Vermaak, Redwaan, Vijn, Frank, Ruperez, Maria, Shanaube, Kwame, Mureithi, Linda, Wapamesa, Chali, Burnett, James M, Kosloff, Barry, de Haas, Petra, Hayes, Richard, Fidler, Sarah, Gachie, Thomas, Schaap, Albertus, Floyd, Sian, Klinkenberg, Eveline, and Ayles, Helen

Published
2023
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22. COVAC1 phase 2a expanded safety and immunogenicity study of a self-amplifying RNA vaccine against SARS-CoV-2

Author

Szubert, Alex J., Pollock, Katrina M., Cheeseman, Hannah M., Alagaratnam, Jasmini, Bern, Henry, Bird, Olivia, Boffito, Marta, Byrne, Ruth, Cole, Tom, Cosgrove, Catherine A., Faust, Saul N., Fidler, Sarah, Galiza, Eva, Hassanin, Hana, Kalyan, Mohini, Libri, Vincenzo, McFarlane, Leon R., Milinkovic, Ana, O'Hara, Jessica, Owen, David R., Owens, Daniel, Pacurar, Mihaela, Rampling, Tommy, Skene, Simon, Winston, Alan, Woolley, James, Yim, Yee Ting N., Dunn, David T., McCormack, Sheena, and Shattock, Robin J.

Published
2023
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23. Early intervention with 3BNC117 and romidepsin at antiretroviral treatment initiation in people with HIV-1: a phase 1b/2a, randomized trial

Author

Gunst, Jesper D., Pahus, Marie H., Rosás-Umbert, Miriam, Lu, I-Na, Benfield, Thomas, Nielsen, Henrik, Johansen, Isik S., Mohey, Rajesh, Østergaard, Lars, Klastrup, Vibeke, Khan, Maryam, Schleimann, Mariane H., Olesen, Rikke, Støvring, Henrik, Denton, Paul W., Kinloch, Natalie N., Copertino, Dennis C., Ward, Adam R., Alberto, Winiffer D. Conce, Nielsen, Silke D., Puertas, Maria C., Ramos, Victor, Reeves, Jacqueline D., Petropoulos, Christos J., Martinez-Picado, Javier, Brumme, Zabrina L., Jones, R. Brad, Fox, Julie, Tolstrup, Martin, Nussenzweig, Michel C., Caskey, Marina, Fidler, Sarah, and Søgaard, Ole S.

Published
2022
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24. What do the Universal Test and Treat trials tell us about the path to HIV epidemic control?

Author

Havlir, Diane, Lockman, Shahin, Ayles, Helen, Larmarange, Joseph, Chamie, Gabriel, Gaolathe, Tendani, Iwuji, Collins, Fidler, Sarah, Kamya, Moses, Floyd, Sian, Moore, Janet, Hayes, Richard, Petersen, Maya, Dabis, Francois, and Test, Treat Trials UT3 Consortium on behalf of the Universal

Subjects
Clinical Trials and Supportive Activities, HIV/AIDS, Behavioral and Social Science, Mental Health, Infectious Diseases, Pediatric, Clinical Research, Prevention, Infection, Good Health and Well Being, AIDS Serodiagnosis, Adolescent, Adult, Anti-HIV Agents, Botswana, Epidemics, Female, HIV Infections, Humans, Incidence, Kenya, Male, Mass Screening, Prevalence, Public Health, South Africa, Time-to-Treatment, Uganda, Viral Load, Zambia, HIV testing, antiretroviral therapy, HIV elimination, HIV care continuum, HIV prevention, public health, universal access, (Universal Test, Treat Trials) UT3 Consortium, Clinical Sciences, Public Health and Health Services, Other Medical and Health Sciences
Abstract

IntroductionAchieving HIV epidemic control globally will require new strategies to accelerate reductions in HIV incidence and mortality. Universal test and treat (UTT) was evaluated in four randomized population-based trials (BCPP/Ya Tsie, HPTN 071/PopART, SEARCH, ANRS 12249/TasP) conducted in sub-Saharan Africa (SSA) during expanded antiretroviral treatment (ART) eligibility by World Health Organization guidelines and the UNAIDS 90-90-90 campaign.DiscussionThese three-year studies were conducted in Botswana, Zambia, Uganda, Kenya and South Africa in settings with baseline HIV prevalence from 4% to 30%. Key observations across studies were: (1) Universal testing (implemented via a variety of home and community-based testing approaches) achieved >90% coverage in all studies. (2) When coupled with robust linkage to HIV care, rapid ART start and patient-centred care, UTT achieved among the highest reported population levels of viral suppression in SSA. Significant gains in population-level viral suppression were made in regions with both low and high baseline population viral load; however, viral suppression gains were not uniform across all sub-populations and were lower among youth. (3) UTT resulted in marked reductions in community HIV incidence when universal testing and robust linkage were present. However, HIV elimination targets were not reached. In BCPP and HPTN 071, annualized HIV incidence was approximately 20% to 30% lower in the intervention (which included universal testing) compared to control arms (no universal testing). In SEARCH (where both arms had universal testing), incidence declined 32% over three years. (4) UTT reduced HIV associated mortality by 23% in the intervention versus control communities in SEARCH, a study in which mortality was comprehensively measured.ConclusionsThese trials provide strong evidence that UTT inclusive of universal testing increases population-level viral suppression and decreases HIV incidence and mortality faster than the status quo in SSA and should be adapted at a sub-country level as a public health strategy. However, more is needed, including integration of new prevention interventions into UTT, in order to reach UNAIDS HIV elimination targets.

Published
2020

25. 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

Author

Hayes, Richard, Fidler, Sarah, Beyers, Nulda, Ayles, Helen, Bock, Peter, El-Sadr, Wafaa, Cohen, Myron, Eshleman, Susan, Agyei, Yaw, Piwowar-Manning, Estelle, Bond, Virginia, Hoddinott, Graeme, Donnell, Deborah, Floyd, Sian, Wilson, Ethan, Emel, Lynda, Noble, Heather, Macleod, David, Burns, David, Fraser, Christophe, Cori, Anne, Sista, Nirupama, Griffith, Sam, Moore, Ayana, Headen, Tanette, White, Rhonda, Miller, Eric, Hargreaves, James, Hauck, Katharina, Thomas, Ranjeeta, Limbada, Mohammed, Bwalya, Justin, Pickles, Michael, Sabapathy, Kalpana, Schaap, Ab, Dunbar, Rory, Shanaube, Kwame, Yang, Blia, Simwinga, Musonda, Smith, Peter, Vermund, Sten, Mandla, Nomtha, Makola, Nozizwe, van Deventer, Anneen, James, Anelet, Jennings, Karen, Kruger, James, Phiri, Mwelwa, Kosloff, Barry, Mwenge, Lawrence, Kanema, Sarah, Sauter, Rafael, Probert, William, Kumar, Ramya, Sakala, Ephraim, Silumesi, Andrew, Skalland, Tim, Yuhas, Krista, Probert, William J M, Bell-Mandla, Nomtha F, Abeler-Dörner, Lucie, Donnell, Deborah J, Skalland, Timothy, and Hayes, Richard J

Published
2022
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26. Impact of universal testing and treatment on sexual risk behaviour and herpes simplex virus type 2: a prespecified secondary outcomes analysis of the HPTN 071 (PopART) community-randomised trial

Author

Wilson, Ethan, Donnell, Deborah, Skalland, Timothy, Floyd, Sian, Moore, Ayana, Bell-Mandla, Nomtha, Bwalya, Justin, Kasese, Nkatya, Dunbar, Rory, Shanaube, Kwame, Kosloff, Barry, Laeyendecker, Oliver, Agyei, Yaw, Hoddinott, Graeme, Bock, Peter, Fidler, Sarah, Hayes, Richard, and Ayles, Helen

Published
2022
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27. Viral suppression and self-reported ART adherence after 3 years of universal testing and treatment in the HPTN 071 (PopART) community-randomised trial in Zambia and South Africa: a cross-sectional analysis

Author

Macleod, David, Shanaube, Kwame, Skalland, Timothy, Limbada, Mohammed, Mandla, Nomtha, Bwalya, Justin, Schaap, Ab, Yang, Blia, Donnell, Deborah, Piwowar-Manning, Estelle, Eshleman, Susan H, Hoddinott, Graeme, Bond, Virginia, Moore, Ayana, Griffith, Sam, Bock, Peter, Ayles, Helen, Fidler, Sarah, Hayes, Richard, and Floyd, Sian

Published
2022
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28. Disseminating complex primary outcome results from a community-randomised trial to Zambian communities: lessons learned using a community dialogue approach in the HPTN 071 (PopART) trial

Author

Simwinga, Musonda, Ndubani, Rhoda, Schaap, Albertus, Ziba, Daniel, Bwalya, Chiti, Belemu, Steve, Ngwenya, Fredrick, Bwalya, Justin, Shanaube, Kwame, Hoddinott, Graeme, White, Rhonda, Bock, Peter, Fidler, Sarah, Hayes, Richard, Seeley, Janet, Ayles, Helen, and Bond, Virginia

Published
2022
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29. Acceptability of and experiences with menstrual hygiene cups among adolescent girls and young women aged 15–24 in two communities in Lusaka, Zambia: an exploratory study nested in the Yathu Yathu trial.

Author

Gondwe, Melleh, Simuyaba, Melvin, Phiri, Mwelwa, Mwansa, Chisanga, Schaap, Albertus, Sigande, Lucheka, Shanaube, Kwame, Floyd, Sian, Fidler, Sarah, Ayles, Helen, Simwinga, Musonda, and Hensen, Bernadette

Subjects
HEALTH literacy, MEDICAL care use, COMMUNITY health services, QUALITATIVE research, REPRODUCTIVE health, RESEARCH funding, CONSUMER attitudes, PSYCHOLOGY of women, THEMATIC analysis, FEMININE hygiene products, METROPOLITAN areas, RESEARCH, MENSTRUATION, SEXUAL health, ADOLESCENCE, ADULTS
Abstract

Background: Menstrual cups could be a sustainable menstrual material for adolescent girls and young women (AGYW) in sub-Saharan Africa. Yathu Yathu was a cluster-randomized trial of community-based delivery of HIV and sexual and reproductive health services to young people in Lusaka, Zambia. Among services available through the intervention were menstrual products, including menstrual cups. We explored knowledge of menstruation and menstrual products, acceptability, and experiences of using cups among AGYW aged 15–24. We share lessons learned on how to distribute cups through community-based strategies to AGYW in urban communities. Methods: Through community-based, peer-led spaces (hubs), AGYW could access menstrual products, including pads and menstrual cups. We conducted four focus group discussions, two with AGYW aged 15–19 (n = 9) and 20–21 (n = 8) who had accessed different menstrual products through Yathu Yathu and two with AGYW aged 15–19 (n = 5) and 20–24 (n = 9) who had accessed menstrual cups. Four interviews were conducted with four AGYW (15–19, n = 2; 20–24, n = 2) who had accessed cups, and four with two AGYW who were enrolled in a qualitative cohort. Data were analyzed thematically. Results: 'Surprise' and 'fear' were initial reactions from most AGYW who saw the cups for the first time at Yathu Yathu hubs. Misconceptions that cups cause cancer and fears that they could get stuck in the vagina, cause sore, vagina enlargement, and loss of virginity were raised by AGYW. The desire to try the cup, use an alternative menstrual product and information gained at the hubs facilitated access. Use of the cup was comfortable, and cups were said to be cost-effective and durable. Advantages over pads included: the absence of odor, easy to maintain, and environmentally friendly: "it is hygienic, and it is even easy to maintain". Challenges included pain, discomfort, and failure to or incorrectly inserting the cup at initial use. When faced with challenges using the cup, AGYW reported going back to the hub for additional information and demonstrations on use. Conclusion: Despite concerns, misconceptions and initial challenges, cups were acceptable among AGYW. Free distribution of cups provides an opportunity to address menstrual health challenges among AGYW. However, as a new product, there is need to increase awareness and provide detailed information on use. [ABSTRACT FROM AUTHOR]

Published
2025
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30. Population‐level analysis of natural control of HIV infection in Zambia and South Africa: HPTN 071 (PopART)

Author

Grant‐Mcauley, Wendy, Piwowar‐Manning, Estelle, Clarke, William, Breaud, Autumn, Zewdie, Kidist Belay, Moore, Ayana, Ayles, Helen Mary, Kosloff, Barry, Shanaube, Kwame, Bock, Peter, Meehan, Sue‐Ann, Maarman, Gerald, Fidler, Sarah, Hayes, Richard, Donnell, Deborah, and Eshleman, Susan H.

Subjects
Observations, Care and treatment, Development and progression, Dosage and administration, Host-virus relationships, HIV infections -- Development and progression -- Care and treatment, AIDS research, Antiretroviral agents -- Dosage and administration, Immune response -- Observations, Antiviral agents -- Dosage and administration, AIDS (Disease) -- Research, HIV infection -- Development and progression -- Care and treatment
Abstract

INTRODUCTION HIV controllers naturally suppress their HIV viral load (VL) to low levels without antiretroviral treatment (ART) [1]. Elite controllers maintain VLs Previous population‐level studies have reported the prevalence of [...], : Introduction: HIV controllers have low viral loads (VL) without antiretroviral treatment (ART). We evaluated viraemic control in a community‐randomized trial conducted in Zambia and South Africa that evaluated the impact of a combination prevention intervention on HIV incidence (HPTN 071 [PopART]; 2013–2018). Methods: VL and antiretroviral (ARV) drug testing were performed using plasma samples collected 2 years after enrolment for 4072 participants who were HIV positive at the start of the study intervention. ARV drug use was assessed using a qualitative laboratory assay that detects 22 ARV drugs in five drug classes. Participants were classified as non‐controllers if they had a VL ≥2000 copies/ml with no ARV drugs detected at this visit. Additional VL and ARV drug testing was performed at a second annual study visit to confirm controller status. Participants were classified as controllers if they had VLs Results: The final cohort included 126 viraemic controllers and 766 non‐controllers who had no ARV drugs detected. The prevalence of controllers among the 4072 persons assessed was 3.1% (95% confidence interval [CI]: 2.6%, 3.6%). This should be considered a minimum estimate, since high rates of ARV drug use in the parent study limited the ability to identify controllers. Among the 892 participants in the final cohort, controller status was associated with biological sex (female > male, p = 0.027). There was no significant association between controller status and age, study country or herpes simplex virus type 2 (HSV‐2) status at study enrolment. Conclusions: To our knowledge, this report presents the first large‐scale, population‐level study evaluating the prevalence of viraemic control and associated factors in Africa. A key advantage of this study was that a biomedical assessment was used to assess ARV drug use (vs. self‐reported data). This study identified a large cohort of HIV controllers and non‐controllers not taking ARV drugs, providing a unique repository of longitudinal samples for additional research. This cohort may be useful for further studies investigating the mechanisms of virologic control.

Published
2023
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32. Safety and immunogenicity of a self-amplifying RNA vaccine against COVID-19: COVAC1, a phase I, dose-ranging trial

Author

Adams, Kirsty, Amini, Fahimah, Atako, Nafisah B, Bakri, Amalina, Barclay, Wendy, Brodnicki, Elizabeth, Brown, Jonathan C, Byrne, Ruth, Chilvers, Rowena, Coelho, Sofia, Day, Suzanne, Desai, Monica, Dorman, Eleanor, Elliott, Tamara, Flight, Katie E, Fletcher, James, Galang, John, Gohil, Jagruti, Gupta, Aneta, Harlow, Chris, Hu, Kai, Kalyan, Mohini, Lagrue, Dominic, Liscano, Ely, Njenga, Cecilia, Polra, Krunal, Powlette, Derecia A, Randell, Paul, Rauchenberger, Mary, Redknap, Ianto, Ricamara, Maravic, Rogers, Paul, Sallah, Hadijatou, Samnuan, Karnyart, Schumacher, Michael, Shah, Zareena, Shaw, Rachel, Shaw, Thomas, Sivapatham, Stefan, Slater, Susie, Sorley, Kim, Storch, Regina, Tan, Elizabeth, Tan, Tricia, Thielemans, Lieze, Whitely, Sarah, Valentine, Charlotte, Varghese, Jeeva, Vikraman, Asha, Wilkins, Martin, Pollock, Katrina M., Cheeseman, Hannah M., Szubert, Alexander J., Libri, Vincenzo, Boffito, Marta, Owen, David, Bern, Henry, McFarlane, Leon R., O'Hara, Jessica, Lemm, Nana-Marie, McKay, Paul, Rampling, Tommy, Yim, Yee Ting N., Milinkovic, Ana, Kingsley, Cherry, Cole, Tom, Fagerbrink, Susanne, Aban, Marites, Tanaka, Maniola, Mehdipour, Savviz, Robbins, Alexander, Budd, William, Faust, Saul, Hassanin, Hana, Cosgrove, Catherine A., Winston, Alan, Fidler, Sarah, Dunn, David, McCormack, Sheena, and Shattock, Robin J.

Published
2022
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33. Rates of viral suppression in a cohort of people with stable HIV from two community models of ART delivery versus facility-based HIV care in Lusaka, Zambia: a cluster-randomised, non-inferiority trial nested in the HPTN 071 (PopART) trial

Author

Hayes, Richard, Fidler, Sarah, Beyers, Nulda, Ayles, Helen, Bock, Peter, El-Sadr, Wafaa, Cohen, Myron, Bond, Virginia, Eshleman, Susan, Donnell, Deborah, Floyd, Sian, Hoddinott, Graeme, Macleod, Dave, Burns, David, Fraser, Christopher, Emel, Lynda, Noble, Heather, Cori, Anne, Sista, Niru, Griffith, Sam, Moore, Ayana, Headen, Tanette, White, Rhonda, Miller, Eric, Hargreaves, James, Hauck, Katharina, Thomas, Ranjeeta, Limbada, Mohammed, Bwalya, Justin, Mwinga, Alwyn, Pickles, Michael, Sabapathy, Kalpana, Schaap, Albertus J, Phiri, Mwelwa, Chiti, Bwalya, Mwenge, Lawrence, Dunbar, Rory, Shanaube, Kwame, Yang, Blia, Simwinga, Musonda, Smith, Peter C, Mandla, Nomtha, Makola, Nozizwe, Van Deventer, Anneen, Sakala, Ephraim, Jennings, Karen, Kosloff, Barry, Kanema, Sarah, Probert, Will, Kumar, Ramya, Silumesi, Andrew, Skalland, Tim, Yuhas, Krista, Macleod, David, Situmbeko, Vasty, Muhau, Ellen, and Shibwela, Osborn

Published
2022
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34. Closing the gap: did delivery approaches complementary to home-based testing reach men with HIV testing services during and after the HPTN 071 (PopART) trial in Zambia?

Author

Phiri, Mwelwa Muleba, Schaap, Ab, Simwinga, Musonda, Hensen, Bernadette, Floyd, Sian, Mulubwa, Chama, Simuyaba, Melvin, Chiti, Bwalya, Bond, Virginia, Shanaube, Kwame, Fidler, Sarah, Hayes, Richard, and Ayles, Helen

Subjects
Statistics, Evaluation, Methods, Men's health, HIV tests -- Methods -- Statistics, Home care services -- Methods -- Statistics, Health promotion -- Methods -- Evaluation, HIV testing -- Methods -- Statistics, Men -- Health aspects, Home care services industry -- Methods -- Statistics
Abstract

1 | INTRODUCTION Data from sub-Saharan African countries consistently show that men are less likely than women to test for HIV [1-3]. In Zambia, the 2013-14 Demographic and Health Survey [...], Introduction: The HPTN 071 (PopART) trialdemonstrated that universalHIV testing-and-treatment reduced community-level HIV incidence. Door-to-door delivery of HIV testing services (HTS) was one of the main components of the intervention. From an early stage, men were less likely to know their HIV status than women, primarily because they were not home during service delivery. To reach more men, different strategies were implemented during the trial. We present the relative contribution of these strategies to coverage of HTS and the impact of community hubs implemented after completion of the trial among men. Methods: Between 2013 and 2017, three intervention rounds (IRs) of door-to-door HTS delivery were conducted in eight PopART communities in Zambia. Additionalstrategies implemented in parallel, included: community-wide "Man-up" campaigns (IR1), smaller HTS campaigns at work/socialplaces (IR2) and revisits to households with the option of HIV self-testing (HIVST) (IR3). In 2018, community "hubs" offering HTS were implemented for 7 months in alleight communities. Population enumeration data for each round of HTS provided the denominator, allowing for calculation of the proportion of men tested as a result of each strategy during different time periods. Results: By the end of the three IRs, 65-75% of men were reached with HTS, primarily through door-to-door service delivery. In IR1 and IR2, "Man-up" and work/socialplace campaigns accounted for ~1 percentage point each and in IR3, revisits with the option of self-testing for ~15 percentage points of this totalcoverage per IR. The yield of newly diagnosed HIV-positive men ranged from 2.2% for HIVST revisits to 9.9% in work/socialplaces. At community hubs, the majority of visitors accepting services were men (62.8%). In total, we estimated that ~36% (2.2% tested HIV positive) of men resident but not found at their household during IR3 of PopART accessed HTS provided at the hubs after trial completion. Conclusions: Achieving high coverage of HTS among men requires universal, home-based service delivery combined with an option of HIVST and delivery of HTS through community-based hubs. When men are reached, they are willing to test for HIV Reaching men thus requires implementers to adapt their HTS delivery strategies to meet men's needs. Clinical Trial Number: NCT01900977 Keywords: men; HIV testing; Zambia; sub-Saharan Africa; community-based

Published
2022
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37. Tuberculosis prevalence after 4 years of population-wide systematic TB symptom screening and universal testing and treatment for HIV in the HPTN 071 (PopART) community-randomised trial in Zambia and South Africa: A cross-sectional survey (TREATS)

Author

Klinkenberg, Eveline, Floyd, Sian, Shanaube, Kwame, Mureithi, Linda, Gachie, Thomas, de Haas, Petra, Kosloff, Barry, Dodd, Peter J., Ruperez, Maria, Wapamesa, Chali, Burnett, James Michael, Kalisvaart, Nico, Kasese, Nkatya, Vermaak, Redwaan, Schaap, Albertus, Fidler, Sarah, Hayes, Richard, and Ayles, Helen

Subjects
Control, Statistics, Diagnosis, Drug therapy, Usage, HIV infections -- Drug therapy -- Diagnosis, Highly active antiretroviral therapy -- Usage, Tuberculosis -- Statistics -- Diagnosis -- Control, HIV infection -- Drug therapy -- Diagnosis
Abstract

Author(s): Eveline Klinkenberg 1,2,3,*, Sian Floyd 1,*, Kwame Shanaube 4, Linda Mureithi 5, Thomas Gachie 1,4, Petra de Haas 3, Barry Kosloff 1,4, Peter J. Dodd 6, Maria Ruperez 1, [...], Background Tuberculosis (TB) prevalence remains persistently high in many settings, with new or expanded interventions required to achieve substantial reductions. The HIV Prevention Trials Network (HPTN) 071 (PopART) community-randomised trial randomised 14 communities to receive the "PopART" intervention during 2014 to 2017 (7 arm A and 7 arm B communities) and 7 communities to receive standard-of-care (arm C). The intervention was delivered door-to-door by community HIV care providers (CHiPs) and included universal HIV testing, facilitated linkage to HIV care at government health clinics, and systematic TB symptom screening. The Tuberculosis Reduction through Expanded Anti-retroviral Treatment and Screening (TREATS) study aimed to measure the impact of delivering the PopART intervention on TB outcomes, in communities with high HIV and TB prevalence. Methods and findings The study population of the HPTN 071 (PopART) trial included individuals aged [greater than or equal to]15 years living in 21 urban and peri-urban communities in Zambia and South Africa, with a total population of approximately 1 million and an adult HIV prevalence of around 15% at the time of the trial. Two sputum samples for TB testing were provided to CHiPs by individuals who reported [greater than or equal to]1 TB suggestive symptom (a cough for [greater than or equal to]2 weeks, unintentional weight loss [greater than or equal to]1.5 kg in the last month, or current night sweats) or that a household member was currently on TB treatment. Antiretroviral therapy (ART) was offered universally at clinics in arm A and according to local guidelines in arms B and C. The TREATS study was conducted in the same 21 communities as the HPTN 071 (PopART) trial between 2017 and 2022, and TB prevalence was a co-primary endpoint of the TREATS study. The primary comparison was between the PopART intervention (arms A and B combined) and the standard-of-care (arm C). During 2019 to 2021, a TB prevalence survey was conducted among randomly selected individuals aged [greater than or equal to]15 years (approximately 1,750 per community in arms A and B, approximately 3,500 in arm C). Participants were screened on TB symptoms and chest X-ray, with diagnostic testing using Xpert-Ultra followed by culture for individuals who screened positive. Sputum eligibility was determined by the presence of a cough for [greater than or equal to]2 weeks, or [greater than or equal to]2 of 5 "TB suggestive" symptoms (cough, weight loss for [greater than or equal to]4 weeks, night sweats, chest pain, and fever for [greater than or equal to]2 weeks), or chest X-ray CAD4TBv5 score [greater than or equal to]50, or no available X-ray results. TB prevalence was compared between trial arms using standard methods for cluster-randomised trials, with adjustment for age, sex, and HIV status, and multiple imputation was used for missing data on prevalent TB. Among 83,092 individuals who were eligible for the survey, 49,556 (59.6%) participated, 8,083 (16.3%) screened positive, 90.8% (7,336/8,083) provided 2 sputum samples for Xpert-Ultra testing, and 308 (4.2%) required culture confirmation. Overall, estimated TB prevalence was 0.92% (457/49,556). The geometric means of 7 community-level prevalence estimates were 0.91%, 0.70%, and 0.69% in arms A, B, and C, respectively, with no evidence of a difference comparing arms A and B combined with arm C (adjusted prevalence ratio 1.14, 95% confidence interval, CI [0.67, 1.95], p = 0.60). TB prevalence was higher among people living with HIV than HIV-negative individuals, with an age-sex-community adjusted odds ratio of 2.29 [95% CI 1.54, 3.41] in Zambian communities and 1.61 [95% CI 1.13, 2.30] in South African communities. The primary limitations are that the study was powered to detect only large reductions in TB prevalence in the intervention arm compared with standard-of-care, and the between-community variation in TB prevalence was larger than anticipated. Conclusions There was no evidence that the PopART intervention reduced TB prevalence. Systematic screening for TB that is based on symptom screening alone may not be sufficient to achieve a large reduction in TB prevalence over a period of several years. Including chest X-ray screening alongside TB symptom screening could substantially increase the sensitivity of systematic screening for TB. Trial registration The TREATS study was registered with ClinicalTrials.gov Identifier: NCT03739736 on November 14, 2018. The HPTN 071 (PopART) trial was registered at ClinicalTrials.gov under number NCT01900977 on July 17, 2013.

Published
2023
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39. Validation of population-level HIV-1 incidence estimation by cross-sectional incidence assays in the HPTN 071 (PopART) trial

Author

Klock, Ethan, Wilson, Ethan, Fernandez, Reinaldo E., Piwowar-Manning, Estelle, Moore, Ayana, Kosloff, Barry, Bwalya, Justin, Bell-Mandla, Nomtha, James, Anelet, Ayles, Helen, Bock, Peter, Donnell, Deborah, Fidler, Sarah, Hayes, Richard, Eshleman, Susan H., and Laeyendecker, Oliver

Subjects
Statistics, Drug therapy, Usage, Risk factors, Algorithm, Clinical trials -- Statistics, Algorithms -- Usage, HIV infections -- Statistics -- Risk factors -- Drug therapy, Biochemical assays -- Usage, HIV infection -- Statistics -- Risk factors -- Drug therapy
Abstract

1 | INTRODUCTION HIV incidence is the rate of new HIV infections in a population and the primary measure in evaluating the state of the epidemic and the effectiveness of [...], Introduction: Cross-sectional incidence testing is used to estimate population-level HIV incidence and measure the impact of prevention interventions. There are limited data evaluating the accuracy of estimates in settings where antiretroviral therapy coverage and levels of viral suppression are high. Understanding cross-sectional incidence estimates in these settings is important as viral suppression can lead to false recent test results. We compared the accuracy of multi-assay algorithms (MAA) for incidence estimation to that observed in the community-randomized HPTN 071 (PopART) trial, where the majority of participants with HIV infection were virally suppressed. Methods: HIV incidence was assessed during the second year of the study, and included only individuals who were tested for HIV at visits 1 and 2 years after the start of the study (2016-2017). Incidence estimates from three MAAs were compared to the observed incidence between years 1 and 2 (MAA-C: LAg-Avidity 400 copies/ml; LAg+VL MAA: LAg-Avidity 1000 copies/ml; Rapid+VL MAA: Asante recent rapid result + VL >1000 copies/ml). The mean duration of recent infection (MDRI) used for the three MAAs was 248, 130 and 180 days, respectively. Results and discussion: The study consisted of: 15,845 HIV-negative individuals; 4406 HIV positive at both visits; and 221 who seroconverted between visits. Viral load (VL) data were available for all HIV-positive participants at the 2-year visit. Sixty four (29%) of the seroconverters and 3227 (72%) prevelant positive participants were virally supressed ( Conclusions: MAA-C and the LAg+VL MAA provided accurate point estimates of incidence in this cohort with high levels of viral suppression. The Rapid+VL significantly underestimated incidence, suggesting that the MDRI recommended by the manufacturer is too long or the assay is not accurately detecting enough recent infections. Keywords: validation study; cross-sectional incidence estimation; sub-Saharan Africa; HPTN; PopART; multi-assay algorithm

Published
2021
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40. The RIO trial: rationale, design, and the role of community involvement in a randomised placebo-controlled trial of antiretroviral therapy plus dual long-acting HIV-specific broadly neutralising antibodies (bNAbs) in participants diagnosed with recent HIV infection—study protocol for a two-stage randomised phase II trial

Author

Lee, Ming Jie, Collins, Simon, Babalis, Daphne, Johnson, Nicholas, Falaschetti, Emanuela, Prevost, A. Toby, Ashraf, Ambreen, Jacob, Milaana, Cole, Tom, Hurley, Lisa, Pace, Matthew, Ogbe, Ane, Khan, Maryam, Zacharopoulou, Panagiota, Brown, Helen, Sutherland, Euan, Box, Hanna, Fox, Julie, Deeks, Steven, Horowitz, Jill, Nussenzweig, Michel C., Caskey, Marina, Frater, John, and Fidler, Sarah

Published
2022
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41. Administration of broadly neutralizing anti-HIV-1 antibodies at ART initiation maintains long-term CD8+ T cell immunity

Author

Rosás-Umbert, Miriam, Gunst, Jesper D., Pahus, Marie H., Olesen, Rikke, Schleimann, Mariane, Denton, Paul W., Ramos, Victor, Ward, Adam, Kinloch, Natalie N., Copertino, Dennis C., Escribà, Tuixent, Llano, Anuska, Brumme, Zabrina L., Brad Jones, R., Mothe, Beatriz, Brander, Christian, Fox, Julie, Nussenzweig, Michel C., Fidler, Sarah, Caskey, Marina, Tolstrup, Martin, and Søgaard, Ole S.

Published
2022
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44. No evidence of neuronal damage as measured by neurofilament light chain in a HIV cure study utilising a kick-and-kill approach

Author

Alagaratnam, Jasmini, Stöhr, Wolfgang, Toombs, Jamie, Heslegrave, Amanda, Zetterberg, Henrik, Gisslén, Magnus, Pett, Sarah, Nelson, Mark, Clarke, Amanda, Nwokolo, Nneka, Johnson, Margaret A., Khan, Maryam, Hanke, Tomas, Kopycinski, Jakub, Dorrell, Lucy, Fox, Julie, Kinloch, Sabine, Underwood, Jonathan, Pace, Matthew, Frater, John, Winston, Alan, and Fidler, Sarah

Published
2021
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45. Safety and immunogenicity of the ChAdOx1 nCoV-19 (AZD1222) vaccine against SARS-CoV-2 in HIV infection: a single-arm substudy of a phase 2/3 clinical trial

Author

Watson, Marion E.E., Song, Rinn, Cicconi, Paola, Minassian, Angela M., Bibi, Sagida, Kerridge, Simon, Singh, Nisha, Green, Catherine M., Douglas, Alexander D., Lawrie, Alison M., Clutterbuck, Elizabeth A., Frater, John, Ewer, Katie J, Ogbe, Ane, Pace, Mathew, Adele, Sandra, Adland, Emily, Alagaratnam, Jasmini, Aley, Parvinder K, Ali, Mohammad, Ansari, M Azim, Bara, Anna, Bittaye, Mustapha, Broadhead, Samantha, Brown, Anthony, Brown, Helen, Cappuccini, Federica, Cooney, Enya, Dejnirattisai, Wanwisa, Dold, Christina, Fairhead, Cassandra, Fok, Henry, Folegatti, Pedro M, Fowler, Jamie, Gibbs, Charlotte, Goodman, Anna L, Jenkin, Daniel, Jones, Mathew, Makinson, Rebecca, Marchevsky, Natalie G, Mujadidi, Yama F, Nguyen, Hanna, Parolini, Lucia, Petersen, Claire, Plested, Emma, Pollock, Katrina M, Ramasamy, Maheshi N, Rhead, Sarah, Robinson, Hannah, Robinson, Nicola, Rongkard, Patpong, Ryan, Fiona, Serrano, Sonia, Tipoe, Timothy, Voysey, Merryn, Waters, Anele, Zacharopoulou, Panagiota, Barnes, Eleanor, Dunachie, Susanna, Goulder, Philip, Klenerman, Paul, Screaton, Gavin R, Winston, Alan, Hill, Adrian V S, Gilbert, Sarah C, Pollard, Andrew J, Fidler, Sarah, Fox, Julie, and Lambe, Teresa

Published
2021
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46. Incoming HIV virion-derived Gag Spacer Peptide 2 (p1) is a target of effective CD8+ T cell antiviral responses

Author

Sandström, Eric, Darbyshire, Janet, Post, Frank, Conlon, Christopher, Anderson, Jane, Maini, Mala, Peto, Timothy, Sasieni, Peter, Miller, Veronica, Weller, Ian, Fidler, Sarah, Frater, John, Babiker, Abdel, Stöhr, Wolfgang, Pett, Sarah, Dorrell, Lucy, Pace, Matthew, Olejniczak, Natalia, Brown, Helen, Robinson, Nicola, Kopycinski, Jakub, Yang, Hongbing, Hanke, Tomáš, Crook, Alison, Kaye, Steven, McClure, Myra, Erlwein, Otto, Lovell, Andrew, Khan, Maryam, Gabrielle, Michelle, Bennett, Rachel, Sy, Aminata, Gregory, Adam, Hudson, Fleur, Russell, Charlotte, Wood, Gemma, Box, Hanna, Kingsley, Cherry, Topping, Katie, Lever, Andrew, Wills, Mark, Fun, Axel, Bandara, Mikaila, Kelly, Damian, Collins, Simon, Markham, Alex, Rauchenberger, Mary, Sowunmi, Yinka, Shidfar, Shaadi, Hague, Dominic, Nelson, Mark, Cerrone, Maddalena, Castrillo Martinez, Nadia, Barber, Tristan, Schoolmeesters, Alexandra, Weaver, Christine, Thunder, Orla, Rowlands, Jane, Higgs, Christopher, Fedele, Serge, Bracchi, Margherita, Thomas, Lervina, Bourke, Peter, Nwokolo, Nneka, Lawrenson, Gaynor, Fiorino, Marzia, Lukha, Hinal, Kinloch-de Loes, Sabine, Johnson, Margaret, Nightingale, Alice, Ngwu, Nnenna, Byrne, Patrick, Cuthbertson, Zoe, Jones, Martin, Fernandez, Tina, Clarke, Amanda, Fisher, Martin, Gleig, Rebecca, Trevitt, Vittorio, Fitzpatrick, Colin, Adams, Tanya, Finnerty, Fiounnuala, Thornhill, John, Lewis, Heather, Kuldanek, Kristin, Fox, Julie, Lwanga, Julianne, Uzu, Hiromi, Lee, Ming, Merle, Simon, O’Rourke, Patrick, Jendrulek, Isabel, Zarko Flynn, Taras, Taylor, Mark, Manuel Tiraboschi, Juan, Murray, Tammy, Llano, Anuska, Cedeño, Samandhy, von Delft, Annette, Corcuera, Angelica, Gillespie, Geraldine M., Knox, Andrew, Leneghan, Darren B., Mothe, Beatriz, Mak, Johnson, Brander, Christian, and Ternette, Nicola

Published
2021
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47. Cost and cost-effectiveness of a universal HIV testing and treatment intervention in Zambia and South Africa: evidence and projections from the HPTN 071 (PopART) trial

Author

Thomas, Ranjeeta, Probert, William J M, Sauter, Rafael, Mwenge, Lawrence, Singh, Surya, Kanema, Sarah, Vanqa, Nosivuyile, Harper, Abigail, Burger, Ronelle, Cori, Anne, Pickles, Michael, Bell-Mandla, Nomtha, Yang, Blia, Bwalya, Justin, Phiri, Mwelwa, Shanaube, Kwame, Floyd, Sian, Donnell, Deborah, Bock, Peter, Ayles, Helen, Fidler, Sarah, Hayes, Richard J, Fraser, Christophe, and Hauck, Katharina

Published
2021
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49. The impact of community-based, peer-led sexual and reproductive health services on knowledge of HIV status among adolescents and young people aged 15 to 24 in Lusaka, Zambia: The Yathu Yathu cluster-randomised trial

Author

Hensen, Bernadette, Floyd, Sian, Phiri, Mwelwa M., Schaap, Ab, Sigande, Lucheka, Simuyaba, Melvin, Mwenge, Lawrence, Zulu-Phiri, Rosemary, Mwape, Louis, Fidler, Sarah, Hayes, Richard, Simwinga, Musonda, and Ayles, Helen

Subjects
Prevention, Analysis, Usage, Risk factors, Health aspects, Teenage pregnancy -- Risk factors -- Prevention, HIV infections -- Risk factors -- Prevention, Teenage sexual behavior -- Analysis, Oral contraceptives -- Usage -- Health aspects
Abstract

Author(s): Bernadette Hensen 1,2,*, Sian Floyd 3, Mwelwa M. Phiri 4, Ab Schaap 3,4, Lucheka Sigande 4, Melvin Simuyaba 4, Lawrence Mwenge 4, Rosemary Zulu-Phiri 4, Louis Mwape 4, Sarah [...], Background The growing population of adolescents and young people (AYP) aged 15 to 24 in sub-Saharan Africa face a high burden of HIV in many settings. Unintended pregnancies among adolescent girls in the region remain high. Nonetheless, the sexual and reproductive health (SRH) service needs of AYP have remained underserved. We conducted a cluster-randomised trial (CRT) to estimate the impact of community-based, peer-led SRH service provision on knowledge of HIV status and other SRH outcomes, including met need for contraceptives. Methods and findings Yathu Yathu was a cluster-randomised trial (CRT) conducted from 2019 to 2021 in 2 urban communities in Lusaka, Zambia. The communities were divided into 20 zones (approximately 2,350 AYP/zone) that were randomly allocated to the Yathu Yathu intervention or control arm. In each intervention zone, a community-based hub, staffed by peer support workers, was established to provide SRH services. In 2019, a census was conducted in all zones; all consenting AYP aged 15 to 24 were given a Yathu Yathu card, which allowed them to accrue points for accessing SRH services at the hub and health facility (intervention arm) or the health facility only (control arm). Points could be exchanged for rewards, thus acting as an incentive to use SRH services in both arms. We conducted a cross-sectional survey in 2021 to estimate the impact of Yathu Yathu on the primary outcome: knowledge of HIV status (self-reporting living with HIV or HIV testing in the last 12 months) and secondary outcomes, including use of pre-exposure prophylaxis (PrEP) in the last 12 months, current use of antiretroviral therapy (ART), and met need for contraceptive services. The sampling was stratified on sex and age group, and we analysed data at cluster-level using a two-stage process recommended for CRTs with Conclusions Delivering community-based, peer-led SRH services increased knowledge of HIV status among AYP, both males and females, compared with the control arm. Scaling up the highly effective Yathu Yathu strategy has the potential to make a substantial contribution to increasing access to HIV prevention and care services for young people. However, additional implementation research is needed to understand how to improve uptake of broader SRH services, beyond uptake of HIV testing. Trial registration ISRCTN75609016, clinicaltrials.gov number NCT04060420

Published
2023
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