1. Anti-retroviral therapy after 'Treat All' in Harare, Zimbabwe: What are the changes in uptake, time to initiation and retention?
- Author
-
Tsitsi Apollo, R. T. Ncube, Takura Matare, Janet Dzangare, Kudakwashe C. Takarinda, Kudzai P.E. Masunda, Hemant Deepak Shewade, Gloria Gonese, Bekezela B Khabo, Regis C Choto, and Innocent Mukeredzi
- Subjects
0301 basic medicine ,Zimbabwe ,medicine.medical_specialty ,Anti-HIV Agents ,time to treatment ,Art initiation ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,Operational research ,General Biochemistry, Genetics and Molecular Biology ,Medication Adherence ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,universal test and treat ,030212 general & internal medicine ,General Pharmacology, Toxicology and Pharmaceutics ,General Immunology and Microbiology ,business.industry ,Ecological study ,HIV ,General Medicine ,Articles ,Antiretroviral therapy ,030112 virology ,ART outcomes ,Patient management ,SORT IT ,Cohort ,Antiretroviral medication ,business ,test and treat ,Cohort study ,Research Article - Abstract
Background: In Zimbabwe, Harare was the first province to implement “Treat All” for people living with human immunodeficiency virus (PLHIV). Since its roll out in July 2016, no study has been conducted to assess the changes in key programme indicators. We compared antiretroviral therapy (ART) uptake, time to ART initiation from diagnosis, and retention before and during “Treat All”. Methods: We conducted an ecological study to assess ART uptake among all PLHIV newly diagnosed before and during “Treat All”. We conducted a cohort study to assess time to ART initiation and retention in care among all PLHIV newly initiated on ART from all electronic patient management system-supported sites (n=50) before and during “Treat All”. Results: ART uptake increased from 65% (n=4619) by the end of quarter one, 2014 to 85% (n=5152) by the end of quarter four, 2018. A cohort of 2289 PLHIV were newly initiated on ART before (April-June 2015) and 1682 during “Treat all” (April-June 2017). Their age and gender distribution was similar. The proportion of PLHIV in early stages of disease was significantly higher during “Treat all” (73.2% vs. 55.6%, p Conclusion: Although there were benefits of early ART initiation during “Treat All”, the programme should consider strategies to improve retention.
- Published
- 2020