HIV Treatment Eligibility Guidelines

CA-IeDEA researchers have been leading several regional and multi-regional initiatives to examine patient outcomes related to the HIV care cascade following the expansion of treatment eligibility criteria. This work includes:

  • Exploring patient outcomes associated with HIV treatment eligibility expansions, such as timeliness and predictors of ART initiation.
  • Determining research priorities to inform the implementation of Treat All policies in sub-Saharan Africa, with the goal of identify and inform strategies for promoting timely uptake of HIV treatment, retention in care, and sustained viral suppression and addressing implementation bottlenecks
  • Examining ART initiation and other patient outcomes in Rwanda following the adoption of Treat All guidelines in July 2016. Findings from one study demonstrate high rates of ART initiation among patients newly enrolling in care after Treat All was introduced, with relatively low loss-to-follow-up. Related analyses are exploring retention in care and viral suppression under Treat All, and a qualitative study is being undertaken explore reasons for non-retention among specific populations.
  • Using mathematical modeling to estimate the health impact of Rwanda’s Treat All policy on lives saved and infections averted over the next decade.
  • Assessing the real-world impact of Treat All policies on rapid ART initiation (initiation within 30 days of enrollment in care) after country-level adoption of Treat All, as well as identying factors associated with failure to initiate ART rapidly under Treat All policies
  • Examining the impact of Treat All policies on timely ART initiation among younger adolescents, aged 10-14 in selected countries in Central, East, and Southern Africa regions of IeDEA.
  • Assessing the status of Treat All implementation at HIV care and treatment sites participating in the global IeDEA consortium and the timing of site-level introduction of Treat All relative to national adoption of universal HIV treatment guidelines.