Language:

The impact of population dynamics on the population HIV care cascade: results from the ANRS 12249 Treatment as Prevention trial in rural KwaZulu‐Natal (South Africa)

Journal of the International AIDS Society, 2018-07, Vol.21 (S4), p.e25128-n/a [Peer Reviewed Journal]

2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society. ;COPYRIGHT 2018 John Wiley & Sons, Inc. ;COPYRIGHT 2018 International AIDS Society ;2018. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Attribution ;ISSN: 1758-2652 ;EISSN: 1758-2652 ;DOI: 10.1002/jia2.25128 ;PMID: 30027600

Full text available

Citations Cited by

Actions
1. Add to My Research
2. Remove from My Research
3. E-mail
4. Print
5. Permalink
6. Citation
7. EasyBib
8. EndNote
9. RefWorks
10. Delicious
11. Export RIS
12. Export BibTeX

Title:
The impact of population dynamics on the population HIV care cascade: results from the ANRS 12249 Treatment as Prevention trial in rural KwaZulu‐Natal (South Africa)
Author: Larmarange, Joseph ; Diallo, Mamadou Hassimiou ; McGrath, Nuala ; Iwuji, Collins ; Plazy, Mélanie ; Thiébaut, Rodolphe ; Tanser, Frank ; Bärnighausen, Till ; Pillay, Deenan ; Dabis, François ; Orne‐Gliemann, Joanna
Subjects: Adults ; Antiretroviral agents ; Clinical trials ; Clinics ; Continuum of care ; Control ; Cross‐sectional cascade ; Diagnosis ; Disease transmission ; Dosage and administration ; Drug resistance ; Drug therapy ; Evaluation ; HIV ; HIV care continuum ; HIV infection ; HIV infections ; Households ; Human health and pathology ; Human immunodeficiency virus ; Infectious diseases ; Life Sciences ; Medical research ; Medical tests ; Medicine, Experimental ; Migration ; Population ; Population biology ; Population dynamics ; Prevention ; Public health ; Risk factors ; Rural areas ; Rural South Africa ; Santé publique et épidémiologie ; Structural drivers
Is Part Of: Journal of the International AIDS Society, 2018-07, Vol.21 (S4), p.e25128-n/a
Description: Introduction The universal test and treat strategy (UTT) was developed to maximize the proportion of all HIV‐positive individuals on antiretroviral treatment (ART) and virally suppressed, assuming that it will lead to a reduction in HIV incidence at the population level. The evolution over time of the cross‐sectional HIV care cascade is determined by individual longitudinal trajectories through the HIV care continuum and underlying population dynamics. The purpose of this paper is to quantify the contribution of each component of population change (in‐ and out‐migration, HIV seroconversion, ageing into the cohort and definitive exit such as death) on the HIV care cascade in the context of the ANRS 12249 Treatment as Prevention (TasP) cluster‐randomized trial, investigating UTT in rural KwaZulu‐Natal, South Africa, between 2012 and 2016. Methods HIV test results and information on clinic visits, ART prescriptions, viral load and CD4 count, migration and deaths were used to calculate residency status, HIV status and HIV care status for each individual on a daily basis. Position within the HIV care continuum was considered as a score ranging from 0 (undiagnosed) to 4 (virally suppressed). We compared the cascade score of each individual joining or leaving the population of resident adults living with HIV with the average score of their cluster at the time of entry or exit. Then, we computed the contribution of each entry or exit on the average cascade score and their annualized total contribution, by component of change. Results While the average cascade score increased over time in all clusters, that increase was constrained by population dynamics. Permanent exits and ageing into the people living with HIV cohort had a marginal effect. Both in‐migrants and out‐migrants were less likely to be retained at each step of the HIV care continuum. However, their overall impact on the cross‐sectional cascade was limited as the effect of in‐ and out‐migration balanced each other. The contribution of HIV seroconversions was negative in all clusters. Conclusions In a context of high HIV incidence, the continuous flow of newly infected individuals slows down the efforts to increase ART coverage and population viral suppression, ultimately attenuating any population‐level impact on HIV incidence. Clinical Trial Number NCT01509508 (clinicalTrials.gov)/DOH‐27‐0512‐3974 (South African National Clinical Trials Register).
Publisher: Switzerland: John Wiley & Sons, Inc
Language: English
Identifier: ISSN: 1758-2652
EISSN: 1758-2652
DOI: 10.1002/jia2.25128
PMID: 30027600
Source: DOAJ : Directory of Open Access Journals
Wiley Blackwell Open Access Collection
Journals@Ovid Open Access Journal Collection Rolling
Geneva Foundation Free Medical Journals at publisher websites
Hyper Article en Ligne (HAL) (Open Access)
PubMed Central
ROAD: Directory of Open Access Scholarly Resources
ProQuest Central

Back to results list


INSPIRE LIBRARY - TON DUC THANG UNIVERSITY	(84-028) 37 755 057	Feedback
19 Nguyen Huu Tho St. Dist.7, HCM	thuvien@tdtu.edu.vn	Feedback

The impact of population dynamics on the population HIV care cascade: results from the ANRS 12249 Treatment as Prevention trial in rural KwaZulu‐Natal (South Africa)

Searching Remote Databases, Please Wait