Implementation of "Treat‐all" at adult HIV care and treatment sites in the Global IeDEA Consortium: results from the Site Assessment Survey. Issue 7 (12th July 2019)

• Record Type: Journal Article
• Authors: 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
• Other Names: Karminia Azar investigator.; Sohn Annette H. investigator.; Allen Debbie investigator.; Bloch Mark investigator.; Boyd Susan investigator.; Brown Katherine investigator.; Costa Jess investigator.; Donohue William investigator.; Gunathilake Manoji investigator.; Hoy Jennifer investigator.; MacRae Karen investigator.; Moore Richard investigator.; Roth Norman investigator.; Rowling Diane investigator.; Silvers Julie investigator.; Smith David J. investigator.; Sowden David investigator.; Templeton David investigator.; Varma Rick investigator.; Woolley Ian investigator.; Youds David investigator.; Chhay Meng Somanithd investigator.; Vannary Bun investigator.; Chan Yun Ting investigator.; Lam Wilson investigator.; Lee Man Po investigator.; Ning Han investigator.; Pansy Yu Po Chu investigator.; Kumarasamy N. investigator.; Pujari Sanjay investigator.; Kurniati Nia investigator.; Merati Tuti Parwati investigator.; Muktiarti Dina investigator.; Parwata Wayan Sandhi investigator.; Ratni Made investigator.; Sukmawati Ni Made Dewi Dian investigator.; Vedaswari Dian Sulistya Putu Diah investigator.; Wati Ketut Dewi Kumara investigator.; Yunihastuty Evy investigator.; Tanuma Junko investigator.; Mills Graham investigator.; Raymond Nigel investigator.; Ditangco Rossana investigator.; Papa Ohnmar Seinn investigator.; Oon Tek Ng investigator.; Ah‐neez investigator.; Azwa Raja investigator.; Dato investigator.; Daud Fauziah investigator.; Juin Wong Ke investigator.; Kamarulzaman Adeeba Binti investigator.; Khairulddin Nik investigator.; Li Chong Meng investigator.; Moy Fong Siew investigator.; Shah Raja Iskandar investigator.; Shyan Wong Peng investigator.; Sim Benedict investigator.; Thahira Jamal Mohamed investigator.; Tuang Koh Mia investigator.; Yusoff Nik investigator.; Choi Jun Yong investigator.; Chan Yu‐Jiun investigator.; Huang Chih‐Sheng investigator.; Wing‐Wai Wong investigator.; Avihingsanon Anchalee investigator.; Chokephaibulkit Kulkanya investigator.; Hansudewechakul Rawiwan investigator.; Khumcha Benjhawan investigator.; Khusuwan Suwimon investigator.; Kiertiburanakul Sasisopin investigator.; Lumbiganon Pagakrong investigator.; Maleesatharn Alan investigator.; Praparattanapan Jutarat investigator.; Puthanakit Thanyawee investigator.; Sricharoenchai Sirintip investigator.; Sudjaritruk Tavitiya investigator.; Watanaporn Suporn investigator.; Thien An Vu investigator.; Cuong Do Duy investigator.; Hằng Bùi Thu investigator.; Huy Bùi Vũ investigator.; Quy Du Tuan investigator.; Van Lam Nguyen investigator.; Baragunzwa Agathomfue investigator.; Gakima Dévote investigator.; Ingabire Gloria investigator.; Kankinoi Floride investigator.; Manyundo Risase Scholastique investigator.; Misago Celestin investigator.; Nahimana Thierry investigator.; Nimbona Pélagie investigator.; Ntirampeba Felicite investigator.; Twizere Christella investigator.; Ajeh Rogers investigator.; Djenabou Amadou investigator.; Dzudie Anastase investigator.; Ewanoge Alice Ndelle investigator.; Tchassem Edmond investigator.; Bampapa Therese investigator.; Lelo Patricia investigator.; Kitetele Faustin investigator.; Paul Marie investigator.; Tytyna Amida investigator.; Akolbout Maryse investigator.; Bitsindou Parfait investigator.; Diafouka Merlin investigator.; Mafoua Adolphe investigator.; Mahinga Nadine investigator.; Moudila Ella investigator.; Moutoula Antoinette investigator.; Ndala Ulrich investigator.; Mahambou Nsonde Dominique investigator.; Ayinkamiye Josephine investigator.; Dusabe Chantal investigator.; Hakizimana Theogene investigator.; Mbaraga Gilbert investigator.; Mukamana Joyce investigator.; Mukantwali Sandrine investigator.; Munyaneza Athanase investigator.; Murangwa Anthere investigator.; Musenguwera J. Claude investigator.; Ngutegure Marie Immanculee investigator.; Ntarambirwa Fidele investigator.; Nyiransabimana Diane investigator.; Sinayobye Jean d'Amour investigator.; Tuyishimire Yvonne investigator.; Uwamahoro Olive investigator.; Uwamahoro Olive investigator.; Viateur Habumuremyi investigator.; Vincent Sugira investigator.; Kuhn Yee Yee investigator.; Musick Beverly investigator.; Rodriguez Israel investigator.; Wools‐Kaloustian Kara investigator.; Yiannoutsos Constantin investigator.; Akajoroit Esinasi investigator.; Ariya Peter investigator.; Atsimale Meshack investigator.; Barua Zeruya investigator.; Busaka Oscar investigator.; Bukusi Elizabeth investigator.; Chebor Valentine investigator.; Chemweno Timothy investigator.; Chirchir John investigator.; Esendi Lameck Diero Sagida investigator.; Fwamba Aisha investigator.; Mmella Anne investigator.; Githumbi Eunice investigator.; Hussein Marcia Nasimiyu investigator.; Kandie Xavier investigator.; Kemunto Martha investigator.; Khaemba Elizabeth investigator.; Kipchumba Mary investigator.; Koech Emily investigator.; Kosgei Caroline investigator.; Laundrick Barasa investigator.; Merongo Ruth investigator.; Mochotto Patricia investigator.; Munyisi Consolata investigator.; Ndakalu Lilian investigator.; Ochieng William Okoth investigator.; Odalo Paul investigator.; Okumu Wicklife investigator.; Omari Lilian investigator.; Omondi Alphoce investigator.; Osia Lydia investigator.; Owino Magret investigator.; Oyoo Maureen investigator.; Pepela Doris investigator.; Rono Millicent investigator.; Simon Omar investigator.; Tenge Angie investigator.; Too Mary investigator.; Toto Modesta investigator.; Towett Cathrine investigator.; Wawire Kennedy investigator.; Kimambo Mensaria investigator.; Kinyota Ester investigator.; Lyamuya Rita investigator.; Mathias Julia investigator.; Mfuko Athuman Ramadhan investigator.; Michael Denna investigator.; Ngonyani Kapella Zacharia investigator.; Nyaga Charles investigator.; Somi G.R. investigator.; Urassa Mark S. investigator.; Batte James investigator.; Bwana Mwebesa Bosco investigator.; Castelnuovo Barbara investigator.; Kanyesigye Michael investigator.; Kisakye Alice investigator.; Nalugoda Fred investigator.; Semuwemba Haruna investigator.; Ssali John investigator.; Ssemakadde Matthew investigator.; Castilho Jessica investigator.; Cesar Carina investigator.; de Alencastro Paulo Ricardo investigator.; Barbosa Eduardo Luiz investigator.; Brites Carlos investigator.; Caricol Renata investigator.; do Carmo Fabiana Bononi investigator.; Coelho Lara Esteves investigator.; Escuder Maria Mercedes investigator.; Estevam Denize Lotufo investigator.; Ferreira Flavia Gomes Faleiro investigator.; Gonçalves Alexandre investigator.; de Fátima Barbosa Gouvêa Aída investigator.; Ikeda Maria Leticia Rodrigues investigator.; Kalichman Artur O. investigator.; Machado Daisy Maria investigator.; Queiroz Simone investigator.; de Alencar Souza Rosa investigator.; Succi Regina Célia investigator.; Trindade Kátia Valeska investigator.; Tupinambás Unai investigator.; Wolff Marcelo investigator.; Rouzier Vanessa investigator.; Padgett Denis investigator.; Crabtree Brenda investigator.; Verne Martin Carlos Eduardo investigator.; Mejia Fernando investigator.; Chang Benny investigator.; Done Brenda investigator.; Gabe Larry investigator.; Gill John investigator.; Gough Kevin investigator.; Howlett Gail investigator.; Klein Marin investigator.; Latendre‐Paquette Judy investigator.; Leung Victor investigator.; MacPhee Paul investigator.; MacPherson P. investigator.; Maharaj Raj investigator.; Medina Lorna Carrasco investigator.; Page Suzanne investigator.; Pexos Costas investigator.; Rachlis Anita investigator.; Salters Kate investigator.; Sterling Sherine investigator.; Boswell Stephen investigator.; Burkholder Greer investigator.; Cesteros Gisela investigator.; Chagaris Kalliope investigator.; Franklin Rosa investigator.; Fuhrer Jack investigator.; Gilbert Cynthia L. investigator.; Goetz Matthew investigator.; Grasso Chris investigator.; Horberg Michael investigator.; Hunter‐Mellado Robert F investigator.; Kell Rita investigator.; Kitahata Mari investigator.; Klein Daniel investigator.; Levine Ken investigator.; Marconi Vincent investigator.; Mathews Christopher investigator.; Mayor Angel M. investigator.; McGowan Catherine investigator.; Moore Richard investigator.; Napravnik Sonia investigator.; Novak Richard investigator.; Oursler Kris Ann investigator.; Ramos Shellier investigator.; Rodriguez Benigno investigator.; Rodriguez Maria C. investigator.; Silverberg Michael investigator.; Simberkoff Michael S. investigator.; Varshney Mohit investigator.; Ward Douglas investigator.; Widick Barb investigator.; Yangco Bienvenido G. investigator.; Davies Mary‐Ann investigator.; Smith Lilian investigator.; von Groote Per Maximilian investigator.; Muhairwe Josephine investigator.; Balakasi Steve investigator.; Banda Quietus investigator.; Kalepa Getrude investigator.; Bauman investigator.; Bello Andrew investigator.; Bulla J.W. investigator.; Chigeda Maria investigator.; Chikaphupha Joyce investigator.; Chikwekwere Flora investigator.; Kachoka Jack investigator.; Kapito Allan investigator.; Katondo Alinafe Nathan investigator.; Kumwenda Molly investigator.; Labein Felix Phewa investigator.; Magombo Ronald investigator.; Malumbe Bridget investigator.; Makuwira I. investigator.; Marico Patricia investigator.; Masangale Betha investigator.; Mchiela Angella investigator.; Midian Dan investigator.; Phiri Kezia investigator.; Tambe Mary investigator.; Thomas Baid investigator.; Thomson Charles investigator.; Hector Jonas investigator.; Cross Anna investigator.; Dlamini Siphephelo investigator.; Eley Brian investigator.; Euvrard Jonathan investigator.; Fatti Geoffrey investigator.; Hilderbrand Katherine investigator.; Hsiao Marvin investigator.; Mpye Michael investigator.; Prozesky Hans investigator.; Reubenson Gary investigator.; Rose Lesley investigator.; Sawry Shobna investigator.; Sibambo Nosisa investigator.; Technau Karl investigator.; Vinikoor Michael investigator.; Chimbetete Cleophas investigator.; Kamenova Kamelia investigator.; Balestre Eric investigator.; Leroy Valeriane investigator.; Malasteste Karen investigator.; Djimon Marcel Zannou investigator.; D'Almeida Marcelline investigator.; Hounhoui Ghislaine investigator.; Assogba Michee investigator.; Zoungrana Jacques investigator.; Yaméogo Issouf investigator.; Tapsoba Achille investigator.; Abdelh Sidibé investigator.; Bosse Clarisse Amani investigator.; Diabaté Mamoudou investigator.; Eboua Tanoh Kassi François investigator.; Folquet Madeleine Amorissani investigator.; Hawelander Denise investigator.; Konaté Mamadou investigator.; Kouakou Kouadio investigator.; Lambert Dohoun investigator.; Minga Albert Kla investigator.; N'gbeche Marie Sylvie investigator.; Tanon Aristophane investigator.; Yao Abo investigator.; Renner Lorna investigator.; N'Diaye Clémentine investigator.; Alima Berthé Mme investigator.; Seydi Moussa investigator.; Tine Judicaël investigator.; Ounoo Elom Takassi investigator.; Kariylare Benjamin investigator.; Patassi Akessiwe investigator.;
• Is Part Of: Journal of the International AIDS Society. Volume 22:Issue 7(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-07-12
• Subjects: HIV -- "Treat all" -- antiretroviral treatment -- HIV care -- guideline implementation; AIDS (Disease) -- Periodicals; HIV infections -- Periodicals; 616.9792005
• DOI: 10.1002/jia2.25331
• Languages: English
• ISSNs: 1758-2652

Abstract

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.