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
Joseph LarmarangeAnrs 12249 Tasp Study Group

Abstract

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. 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 lea...Continue Reading

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Citations

Oct 29, 2019·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Marie A BraultSten H Vermund
Oct 28, 2019·Annual Review of Medicine·Myron S CohenMarybeth McCauley
Jul 22, 2018·Journal of the International AIDS Society·Carol S CamlinJanet Seeley
Jul 22, 2018·Journal of the International AIDS Society·Susan CasselsJanet Seeley
Oct 23, 2019·Journal of the International AIDS Society·Joseph LarmarangeUNKNOWN ANRS 12249 TasP Study Group
Jun 30, 2019·Infectious Disease Clinics of North America·Claire E Farel, Ann M Dennis

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Methods Mentioned

BETA
ELISA

Clinical Trials Mentioned

NCT01509508

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