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1. Associations between HIV stigma and health-related quality-of-life among people living with HIV: cross-sectional analysis of data from HPTN 071 (PopART)

Author

Hall, Emily, Davis, Katherine, Ohrnberger, Julius, Pickles, Michael, Gregson, Simon, Thomas, Ranjeeta, Hargreaves, James R., Pliakas, Triantafyllos, Bwalya, Justin, Dunbar, Rory, Mainga, Tila, Shanaube, Kwame, Hoddinott, Graeme, Bond, Virginia, Bock, Peter, Ayles, Helen, Stangl, Anne L., Donnell, Deborah, Hayes, Richard, Fidler, Sarah, and Hauck, Katharina

Published
2024
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3. Demographics of sources of HIV-1 transmission in Zambia: a molecular epidemiology analysis in the HPTN 071 PopART study

Author

Agyei, Yaw, Beyers, Nulda, Bock, Peter, Bond, Virginia, Bwalya, Justin, Cori, Anne, Deventer, Anneen, Dunbar, Rory, El-Sadr, Wafaa, Emel, Lynda, Floyd, Sian, Griffith, Sam, Hargreaves, James, Hauck, Katharina, Headen, Tanette, Hoddinott, Graeme, James, Anelet, Jennings, Karen, Kanema, Sarah, Kosloff, Barry, Kruger, James, Kumar, Ramya, Macleod, David, Makola, Nozizwe, Mandla, Nomtha, Miller, Eric, Moore, Ayana, Mwenge, Lawrence, Noble, Heather, Phiri, Mwelwa, Pickles, Michael, Sabapathy, Kalpana, Sakala, Ephraim, Sauter, Rafael, Shanaube, Kwame, Silumesi, Andrew, Sista, Nirupama, Skalland, Tim, Smith, Peter, Thomas, Ranjeeta, Vermund, Sten, White, Rhonda, Wilson, Ethan, Yang, Blia, Yuhas, Krista, Bowden, Rory, Calvez, Vincent, Essex, Max, Grabowski, Kate, Gupta, Ravindra, Herbeck, Joshua, Kagaayi, Joseph, Kaleebu, Pontiano, Lingappa, Jairam, Moyo, Sikhulile, Novitsky, Vladimir, Ndung’u, Thumbi, Pillay, Deenan, Quinn, Thomas, Rambaut, Andrew, Seeley, Janet, Ssemwanga, Deogratius, Tanser, Frank, Wawer, Maria, Hall, Matthew, Golubchik, Tanya, Bonsall, David, Abeler-Dörner, Lucie, Limbada, Mohammed, Schaap, Ab, de Cesare, Mariateresa, MacIntyre-Cockett, George, Otecko, Newton, Probert, William, Ratmann, Oliver, Bulas Cruz, Ana, Piwowar-Manning, Estelle, Burns, David N, Cohen, Myron S, Donnell, Deborah J, Eshleman, Susan H, Simwinga, Musonda, Fidler, Sarah, Hayes, Richard, Ayles, Helen, and Fraser, Christophe

Published
2024
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6. The effect of universal testing and treatment for HIV on health-related quality of life – An analysis of data from the HPTN 071 (PopART) cluster randomised trial

Author

Davis, Katherine, Pickles, Michael, Gregson, Simon, Hargreaves, James R., Ayles, Helen, Bock, Peter, Pliakas, Triantafyllos, Thomas, Ranjeeta, Ohrnberger, Julius, Bwalya, Justin, Bell-Mandla, Nomtha, Shanaube, Kwame, Probert, William, Hoddinott, Graeme, Bond, Virginia, Hayes, Richard, Fidler, Sarah, and Hauck, Katharina

Published
2023
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7. Projected outcomes of universal testing and treatment in a generalised HIV epidemic in Zambia and South Africa (the HPTN 071 [PopART] trial): a modelling study

Author

Hayes, Richard, Fidler, Sarah, Beyers, Nulda, Ayles, Helen, Bock, Peter, El-Sadr, Wafaa, Cohen, Myron, Eshleman, Susan, Agyei, Yaw, Piwowar-Manning, Estelle, Bond, Virginia, Hoddinott, Graeme, Donnell, Deborah, Floyd, Sian, Wilson, Ethan, Emel, Lynda, Noble, Heather, Macleod, David, Burns, David, Fraser, Christophe, Cori, Anne, Sista, Nirupama, Griffith, Sam, Moore, Ayana, Headen, Tanette, White, Rhonda, Miller, Eric, Hargreaves, James, Hauck, Katharina, Thomas, Ranjeeta, Limbada, Mohammed, Bwalya, Justin, Pickles, Michael, Sabapathy, Kalpana, Schaap, Ab, Dunbar, Rory, Shanaube, Kwame, Yang, Blia, Simwinga, Musonda, Smith, Peter, Vermund, Sten, Mandla, Nomtha, Makola, Nozizwe, van Deventer, Anneen, James, Anelet, Jennings, Karen, Kruger, James, Phiri, Mwelwa, Kosloff, Barry, Mwenge, Lawrence, Kanema, Sarah, Sauter, Rafael, Probert, William, Kumar, Ramya, Sakala, Ephraim, Silumesi, Andrew, Skalland, Tim, Yuhas, Krista, Probert, William J M, Bell-Mandla, Nomtha F, Abeler-Dörner, Lucie, Donnell, Deborah J, Skalland, Timothy, and Hayes, Richard J

Published
2022
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8. Impact of universal testing and treatment on sexual risk behaviour and herpes simplex virus type 2: a prespecified secondary outcomes analysis of the HPTN 071 (PopART) community-randomised trial

Author

Wilson, Ethan, Donnell, Deborah, Skalland, Timothy, Floyd, Sian, Moore, Ayana, Bell-Mandla, Nomtha, Bwalya, Justin, Kasese, Nkatya, Dunbar, Rory, Shanaube, Kwame, Kosloff, Barry, Laeyendecker, Oliver, Agyei, Yaw, Hoddinott, Graeme, Bock, Peter, Fidler, Sarah, Hayes, Richard, and Ayles, Helen

Published
2022
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9. Viral suppression and self-reported ART adherence after 3 years of universal testing and treatment in the HPTN 071 (PopART) community-randomised trial in Zambia and South Africa: a cross-sectional analysis

Author

Macleod, David, Shanaube, Kwame, Skalland, Timothy, Limbada, Mohammed, Mandla, Nomtha, Bwalya, Justin, Schaap, Ab, Yang, Blia, Donnell, Deborah, Piwowar-Manning, Estelle, Eshleman, Susan H, Hoddinott, Graeme, Bond, Virginia, Moore, Ayana, Griffith, Sam, Bock, Peter, Ayles, Helen, Fidler, Sarah, Hayes, Richard, and Floyd, Sian

Published
2022
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10. Disseminating complex primary outcome results from a community-randomised trial to Zambian communities: lessons learned using a community dialogue approach in the HPTN 071 (PopART) trial

Author

Simwinga, Musonda, Ndubani, Rhoda, Schaap, Albertus, Ziba, Daniel, Bwalya, Chiti, Belemu, Steve, Ngwenya, Fredrick, Bwalya, Justin, Shanaube, Kwame, Hoddinott, Graeme, White, Rhonda, Bock, Peter, Fidler, Sarah, Hayes, Richard, Seeley, Janet, Ayles, Helen, and Bond, Virginia

Published
2022
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11. Rates of viral suppression in a cohort of people with stable HIV from two community models of ART delivery versus facility-based HIV care in Lusaka, Zambia: a cluster-randomised, non-inferiority trial nested in the HPTN 071 (PopART) trial

Author

Hayes, Richard, Fidler, Sarah, Beyers, Nulda, Ayles, Helen, Bock, Peter, El-Sadr, Wafaa, Cohen, Myron, Bond, Virginia, Eshleman, Susan, Donnell, Deborah, Floyd, Sian, Hoddinott, Graeme, Macleod, Dave, Burns, David, Fraser, Christopher, Emel, Lynda, Noble, Heather, Cori, Anne, Sista, Niru, Griffith, Sam, Moore, Ayana, Headen, Tanette, White, Rhonda, Miller, Eric, Hargreaves, James, Hauck, Katharina, Thomas, Ranjeeta, Limbada, Mohammed, Bwalya, Justin, Mwinga, Alwyn, Pickles, Michael, Sabapathy, Kalpana, Schaap, Albertus J, Phiri, Mwelwa, Chiti, Bwalya, Mwenge, Lawrence, Dunbar, Rory, Shanaube, Kwame, Yang, Blia, Simwinga, Musonda, Smith, Peter C, Mandla, Nomtha, Makola, Nozizwe, Van Deventer, Anneen, Sakala, Ephraim, Jennings, Karen, Kosloff, Barry, Kanema, Sarah, Probert, Will, Kumar, Ramya, Silumesi, Andrew, Skalland, Tim, Yuhas, Krista, Macleod, David, Situmbeko, Vasty, Muhau, Ellen, and Shibwela, Osborn

Published
2022
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12. Validation of population-level HIV-1 incidence estimation by cross-sectional incidence assays in the HPTN 071 (PopART) trial

Author

Klock, Ethan, Wilson, Ethan, Fernandez, Reinaldo E., Piwowar-Manning, Estelle, Moore, Ayana, Kosloff, Barry, Bwalya, Justin, Bell-Mandla, Nomtha, James, Anelet, Ayles, Helen, Bock, Peter, Donnell, Deborah, Fidler, Sarah, Hayes, Richard, Eshleman, Susan H., and Laeyendecker, Oliver

Subjects
Statistics, Drug therapy, Usage, Risk factors, Algorithm, Clinical trials -- Statistics, Algorithms -- Usage, HIV infections -- Statistics -- Risk factors -- Drug therapy, Biochemical assays -- Usage, HIV infection -- Statistics -- Risk factors -- Drug therapy
Abstract

1 | INTRODUCTION HIV incidence is the rate of new HIV infections in a population and the primary measure in evaluating the state of the epidemic and the effectiveness of [...], Introduction: Cross-sectional incidence testing is used to estimate population-level HIV incidence and measure the impact of prevention interventions. There are limited data evaluating the accuracy of estimates in settings where antiretroviral therapy coverage and levels of viral suppression are high. Understanding cross-sectional incidence estimates in these settings is important as viral suppression can lead to false recent test results. We compared the accuracy of multi-assay algorithms (MAA) for incidence estimation to that observed in the community-randomized HPTN 071 (PopART) trial, where the majority of participants with HIV infection were virally suppressed. Methods: HIV incidence was assessed during the second year of the study, and included only individuals who were tested for HIV at visits 1 and 2 years after the start of the study (2016-2017). Incidence estimates from three MAAs were compared to the observed incidence between years 1 and 2 (MAA-C: LAg-Avidity 400 copies/ml; LAg+VL MAA: LAg-Avidity 1000 copies/ml; Rapid+VL MAA: Asante recent rapid result + VL >1000 copies/ml). The mean duration of recent infection (MDRI) used for the three MAAs was 248, 130 and 180 days, respectively. Results and discussion: The study consisted of: 15,845 HIV-negative individuals; 4406 HIV positive at both visits; and 221 who seroconverted between visits. Viral load (VL) data were available for all HIV-positive participants at the 2-year visit. Sixty four (29%) of the seroconverters and 3227 (72%) prevelant positive participants were virally supressed ( Conclusions: MAA-C and the LAg+VL MAA provided accurate point estimates of incidence in this cohort with high levels of viral suppression. The Rapid+VL significantly underestimated incidence, suggesting that the MDRI recommended by the manufacturer is too long or the assay is not accurately detecting enough recent infections. Keywords: validation study; cross-sectional incidence estimation; sub-Saharan Africa; HPTN; PopART; multi-assay algorithm

Published
2021
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13. Cost and cost-effectiveness of a universal HIV testing and treatment intervention in Zambia and South Africa: evidence and projections from the HPTN 071 (PopART) trial

Author

Thomas, Ranjeeta, Probert, William J M, Sauter, Rafael, Mwenge, Lawrence, Singh, Surya, Kanema, Sarah, Vanqa, Nosivuyile, Harper, Abigail, Burger, Ronelle, Cori, Anne, Pickles, Michael, Bell-Mandla, Nomtha, Yang, Blia, Bwalya, Justin, Phiri, Mwelwa, Shanaube, Kwame, Floyd, Sian, Donnell, Deborah, Bock, Peter, Ayles, Helen, Fidler, Sarah, Hayes, Richard J, Fraser, Christophe, and Hauck, Katharina

Published
2021
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15. Determination of HIV status and identification of incident HIV infections in a large, community-randomized trial: HPTN 071 (PopART)

Author

Eshleman, Susan H., Piwowar-Manning, Estelle, Wilson, Ethan A., Lennon, Denni, Fogel, Jessica M., Agyei, Yaw, Sullivan, Philip A., Weng, Lei, Moore, Ayana, Laeyendecker, Oliver, Kosloff, Barry, Bwalya, Justin, Maarman, Gerald, van Deventer, Anneen, Floyd, Sian, Bock, Peter, Ayles, Helen, Fidler, Sarah, Hayes, Richard, and Donnell, Deborah

Subjects
Prevention, Analysis, Health aspects, Algorithm, Clinical trials -- Analysis -- Health aspects, Health screening -- Analysis -- Health aspects, Algorithms -- Health aspects -- Analysis, HIV infections -- Prevention, HIV -- Prevention, Medical research -- Analysis -- Health aspects
Abstract

(1) | INTRODUCTION Universal testing and treatment (UTT) for HIV prevention is an important component of HIV prevention programmes [1,2]. The HIV Prevention Trials Network (HPTN) 071 (PopART) trial, the [...], Introduction: The HPTN 071 (PopART) trial evaluated the impact of an HIV combination prevention package that included 'universal testing and treatment' on HIV incidence in 21 communities in Zambia and South Africa during 2013-2018. The primary study endpoint was based on the results of laboratory-based HIV testing for> 48,000 participants who were followed for up to three years. This report evaluated the performance of HIV assays and algorithms used to determine HIV status and identify incident HIV infections in HPTN 071, and assessed the impact of errors on HIV incidence estimates. Methods: HIV status was determined using a streamlined, algorithmic approach. A single HIV screening test was performed at centralized laboratories in Zambia and South Africa (all participants, all visits). Additional testing was performed at the HPTN Laboratory Center using antigen/antibody screening tests, a discriminatory test and an HIV RNA test. This testing was performed to investigate cases with discordant test results and confirm incident HIV infections. Results: HIV testing identified 978 seroconverter cases. This included 28 cases where the participant had acute HIV infection at the first HIV-positive visit. Investigations of cases with discordant test results identified cases where there was a participant or sample error (mixups). Seroreverter cases (errors where status changed from HIV infected to HIV uninfected, 0.4% of all cases) were excluded from the primary endpoint analysis. Statistical analysis demonstrated that exclusion of those cases improved the accuracy of HIV incidence estimates. Conclusions: This report demonstrates that the streamlined, algorithmic approach effectively identified HIV infections in this arge cluster-randomized trial. Longitudinal HIV testing (all participants, all visits) and quality control testing provided usefu data on the frequency of errors and provided more accurate data for HIV incidence estimates. Keywords: HIV incidence; seroconverters; HIV testing; community-randomized; Zambia; South Africa

Published
2020
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16. Demographics of sources of HIV-1 transmission in Zambia: a molecular epidemiology analysis in the HPTN 071 PopART study

Author

Hall, Matthew, primary, Golubchik, Tanya, additional, Bonsall, David, additional, Abeler-Dörner, Lucie, additional, Limbada, Mohammed, additional, Kosloff, Barry, additional, Schaap, Ab, additional, de Cesare, Mariateresa, additional, MacIntyre-Cockett, George, additional, Otecko, Newton, additional, Probert, William, additional, Ratmann, Oliver, additional, Bulas Cruz, Ana, additional, Piwowar-Manning, Estelle, additional, Burns, David N, additional, Cohen, Myron S, additional, Donnell, Deborah J, additional, Eshleman, Susan H, additional, Simwinga, Musonda, additional, Fidler, Sarah, additional, Hayes, Richard, additional, Ayles, Helen, additional, Fraser, Christophe, additional, Agyei, Yaw, additional, Beyers, Nulda, additional, Bock, Peter, additional, Bond, Virginia, additional, Bwalya, Justin, additional, Cori, Anne, additional, Deventer, Anneen, additional, Dunbar, Rory, additional, El-Sadr, Wafaa, additional, Emel, Lynda, additional, Floyd, Sian, additional, Griffith, Sam, additional, Hargreaves, James, additional, Hauck, Katharina, additional, Headen, Tanette, additional, Hoddinott, Graeme, additional, James, Anelet, additional, Jennings, Karen, additional, Kanema, Sarah, additional, Kruger, James, additional, Kumar, Ramya, additional, Macleod, David, additional, Makola, Nozizwe, additional, Mandla, Nomtha, additional, Miller, Eric, additional, Moore, Ayana, additional, Mwenge, Lawrence, additional, Noble, Heather, additional, Phiri, Mwelwa, additional, Pickles, Michael, additional, Sabapathy, Kalpana, additional, Sakala, Ephraim, additional, Sauter, Rafael, additional, Shanaube, Kwame, additional, Silumesi, Andrew, additional, Sista, Nirupama, additional, Skalland, Tim, additional, Smith, Peter, additional, Thomas, Ranjeeta, additional, Vermund, Sten, additional, White, Rhonda, additional, Wilson, Ethan, additional, Yang, Blia, additional, Yuhas, Krista, additional, Bowden, Rory, additional, Calvez, Vincent, additional, Essex, Max, additional, Grabowski, Kate, additional, Gupta, Ravindra, additional, Herbeck, Joshua, additional, Kagaayi, Joseph, additional, Kaleebu, Pontiano, additional, Lingappa, Jairam, additional, Moyo, Sikhulile, additional, Novitsky, Vladimir, additional, Ndung’u, Thumbi, additional, Pillay, Deenan, additional, Quinn, Thomas, additional, Rambaut, Andrew, additional, Seeley, Janet, additional, Ssemwanga, Deogratius, additional, Tanser, Frank, additional, and Wawer, Maria, additional

Published
2023
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17. PA-777 Establishing and navigating community engagement during the COVID-19 pandemic: lessons learned from Zambia

Author

Simwinga, Musonda, primary, Mshanga, Isaac, additional, Witola, Gracious, additional, Simuyaba, Melvin, additional, Mukwasa, Leah, additional, Nawelwa, Alice, additional, Kanemeka, Benson, additional, Bwalya, Justin, additional, Schaap, Albertus, additional, Klinkenberg, Eveline, additional, Hayes, Richard, additional, Shanaube, Kwame, additional, Ayles, Helen, additional, and Bond, Virginia, additional

Published
2023
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18. Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa: a cross-sectional baseline survey of the HPTN 071 (PopART) trial

Author

Hargreaves, James, Watson-Jones, Deborah, Godfrey-Faussett, Peter, Cori, Anne, Pickles, Mike, Mandla, Nomtha, Yang, Blia, James, Anelet, Vermaak, Redwaan, Makola, Nozizwe, Hoddinott, Graeme, Naidoo, Vikesh, Bond, Virginia, Simwinga, Musonda, Mwinga, Alwyn, Kosloff, Barry, Limbada, Mohammed, Bwalya, Justin, Ngulube, Chepela, Fraser, Christophe, Eshleman, Susan, Agyei, Yaw, Cummings, Vanessa, Catalano, Denni, Emel, Lynda, Bunts, Lisa, Noble, Heather, Burns, David, Kouda, Alain, Sista, Niru, Moore, Ayana, White, Rhonda, Headen, Tanette, Miller, Eric, Hinson, Kathy, Vermund, Sten, Barnes, Mark, Horn, Lyn, Mwango, Albert, Baldwin, Megan, Wolf, Shauna, Hughes, Erin, Thomas, Ranjeeta, Burger, Ronelle, Harper, Abigail, Kanema, Sarah, Mwenge, Lawrence, Vanqa, Nosivuyile, Bell-Mandla, Nomtha, Smith, Peter C, Floyd, Sian, Bock, Peter, Ayles, Helen, Beyers, Nulda, Donnell, Deborah, Fidler, Sarah, Hayes, Richard, and Hauck, Katharina

Published
2017
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19. Predictors of participant retention in a community-based HIV prevention cohort: perspectives from the HPTN 071 (PopART) study

Author

Bell-Mandla, Nomtha, primary, Sloot, Rosa, additional, WIlson, Ethan, additional, Sharma, Deeksha, additional, Floyd, Sian, additional, Moore, Ayana, additional, Piwowar-Manning, Estelle, additional, Makola, Nozizwe, additional, Bwalya, Justin, additional, Simwinga, Musonda, additional, Nkonki, Lungiswa, additional, Schaap, Ab, additional, Donnell, Deborah, additional, Ayles, Helen, additional, Fidler, Sarah, additional, Hayes, Richard, additional, and Bock, Peter Alwin, additional

Published
2022
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20. Projected outcomes of universal testing and treatment in a generalised HIV epidemic in Zambia and South Africa (the HPTN 071 [PopART] trial): a modelling study

Author

Probert, William J M, primary, Sauter, Rafael, additional, Pickles, Michael, additional, Cori, Anne, additional, Bell-Mandla, Nomtha F, additional, Bwalya, Justin, additional, Abeler-Dörner, Lucie, additional, Bock, Peter, additional, Donnell, Deborah J, additional, Floyd, Sian, additional, Macleod, David, additional, Piwowar-Manning, Estelle, additional, Skalland, Timothy, additional, Shanaube, Kwame, additional, Wilson, Ethan, additional, Yang, Blia, additional, Ayles, Helen, additional, Fidler, Sarah, additional, Hayes, Richard J, additional, Fraser, Christophe, additional, Hayes, Richard, additional, Beyers, Nulda, additional, El-Sadr, Wafaa, additional, Cohen, Myron, additional, Eshleman, Susan, additional, Agyei, Yaw, additional, Bond, Virginia, additional, Hoddinott, Graeme, additional, Donnell, Deborah, additional, Emel, Lynda, additional, Noble, Heather, additional, Burns, David, additional, Sista, Nirupama, additional, Griffith, Sam, additional, Moore, Ayana, additional, Headen, Tanette, additional, White, Rhonda, additional, Miller, Eric, additional, Hargreaves, James, additional, Hauck, Katharina, additional, Thomas, Ranjeeta, additional, Limbada, Mohammed, additional, Sabapathy, Kalpana, additional, Schaap, Ab, additional, Dunbar, Rory, additional, Simwinga, Musonda, additional, Smith, Peter, additional, Vermund, Sten, additional, Mandla, Nomtha, additional, Makola, Nozizwe, additional, van Deventer, Anneen, additional, James, Anelet, additional, Jennings, Karen, additional, Kruger, James, additional, Phiri, Mwelwa, additional, Kosloff, Barry, additional, Mwenge, Lawrence, additional, Kanema, Sarah, additional, Probert, William, additional, Kumar, Ramya, additional, Sakala, Ephraim, additional, Silumesi, Andrew, additional, Skalland, Tim, additional, and Yuhas, Krista, additional

Published
2022
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21. Community‐ and individual‐level correlates of HIV incidence in HPTN 071 (PopART).

Author

Skalland, Timothy, Ayles, Helen, Bock, Peter, Bwalya, Justin, Shanaube, Kwame, Kasese, Nkatya, Dupré, Michelle, Kosloff, Barry, Floyd, Sian, Wilson, Ethan, Moore, Ayana, Eshleman, Susan, Fidler, Sarah, Hayes, Richard, and Donnell, Deborah

Subjects
HIV seroconversion, HIV, HIV infection transmission, VIRAL load, HUMAN sexuality, HIV prevention
Abstract

Introduction: Universal HIV testing and treatment aims to identify all people living with HIV and offer them treatment, decreasing the number of individuals with unsuppressed HIV and thus reducing HIV transmission. Longitudinal follow‐up of individuals with and without HIV in a cluster‐randomized trial of communities allowed for the examination of community‐ and individual‐level measures of HIV risk and HIV incidence. Methods: HPTN 071 (PopART) was a three‐arm cluster‐randomized trial conducted between 2013 and 2018 that evaluated the use of two combination HIV prevention strategies implemented at the community level to reduce HIV incidence compared to the standard of care. The trial, conducted in 21 communities in Zambia and South Africa, measured HIV incidence over 36 months in a population cohort of ∼2000 randomly selected adults per community aged 18–44. Multilevel models were used to assess the association between HIV incidence and community‐ and individual‐level socio‐demographic and behavioural risk factors, as well as prevalence of detectable virus (PDV) defined as the estimated proportion of the community with unsuppressed viral load. Results: Overall HIV incidence was 1.49/100 person‐years. Communities with less financial wealth and communities with more individuals reporting having sex partners outside of the community or two or more sexual partners had higher HIV incidence. PDV at 2 years of study was 6.8% and was strongly associated with HIV incidence: for every 50% relative reduction in community PDV, there was a 49% (95% confidence interval [CI]: 37%–58%, p < 0.001) relative decrease in HIV incidence. At the individual level; socio‐economic status, AUDIT score, medical male circumcision and certain sexual behaviours were associated with HIV risk. Conclusions: Using data from the PopART randomized trial, we found several associations of HIV incidence with community‐level measures reflecting the sexual behaviour and socio‐economic make‐up of each community. We also found a strong association between community PDV and HIV incidence supporting the use of PDV as a tool for monitoring progress in controlling the epidemic. Lastly, we found significant individual‐level factors of HIV risk that are generally consistent with previous HIV epidemiological research. These results have the potential to identify high high‐incidence communities, inform structural‐level interventions, and optimize individual‐level interventions for HIV prevention. Clinical Trial Number: ClinicalTrials.gov number, NCT01900977, HPTN 071 [PopArt] [ABSTRACT FROM AUTHOR]

Published
2023
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22. Rates of viral suppression in a cohort of people with stable HIV from two community models of ART delivery versus facility-based HIV care in Lusaka, Zambia: a cluster-randomised, non-inferiority trial nested in the HPTN 071 (PopART) trial

Author

Limbada, Mohammed, primary, Macleod, David, additional, Situmbeko, Vasty, additional, Muhau, Ellen, additional, Shibwela, Osborn, additional, Chiti, Bwalya, additional, Floyd, Sian, additional, Schaap, Albertus J, additional, Hayes, Richard, additional, Fidler, Sarah, additional, Ayles, Helen, additional, Beyers, Nulda, additional, Bock, Peter, additional, El-Sadr, Wafaa, additional, Cohen, Myron, additional, Bond, Virginia, additional, Eshleman, Susan, additional, Donnell, Deborah, additional, Hoddinott, Graeme, additional, Macleod, Dave, additional, Burns, David, additional, Fraser, Christopher, additional, Emel, Lynda, additional, Noble, Heather, additional, Cori, Anne, additional, Sista, Niru, additional, Griffith, Sam, additional, Moore, Ayana, additional, Headen, Tanette, additional, White, Rhonda, additional, Miller, Eric, additional, Hargreaves, James, additional, Hauck, Katharina, additional, Thomas, Ranjeeta, additional, Limbada, Mohammed, additional, Bwalya, Justin, additional, Mwinga, Alwyn, additional, Pickles, Michael, additional, Sabapathy, Kalpana, additional, Phiri, Mwelwa, additional, Mwenge, Lawrence, additional, Dunbar, Rory, additional, Shanaube, Kwame, additional, Yang, Blia, additional, Simwinga, Musonda, additional, Smith, Peter C, additional, Mandla, Nomtha, additional, Makola, Nozizwe, additional, Van Deventer, Anneen, additional, Sakala, Ephraim, additional, Jennings, Karen, additional, Kosloff, Barry, additional, Kanema, Sarah, additional, Probert, Will, additional, Kumar, Ramya, additional, Silumesi, Andrew, additional, Skalland, Tim, additional, and Yuhas, Krista, additional

Published
2022
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23. Female Genital Schistosomiasis and HIV-1 Incidence in Zambian Women: A Retrospective Cohort Study

Author

Sturt, Amy S, Webb, Emily L, Phiri, Comfort R, Mudenda, Maina, Mapani, Joyce, Kosloff, Barry, Cheeba, Maina, Shanaube, Kwame, Bwalya, Justin, Kjetland, Eyrun F, Francis, Suzanna C, Corstjens, Paul LAM, van Dam, Govert J, van Lieshout, Lisette, Hansingo, Isaiah, Ayles, Helen, Hayes, Richard J, and Bustinduy, Amaya L

Abstract

BACKGROUND: Female genital schistosomiasis (FGS) has been associated with prevalent HIV-1. We estimated the incidence of HIV-1 infection in Zambian women with and without FGS. METHODS: Women (aged 18-31, nonpregnant, sexually active) were invited to participate in this study in January-August 2018 at the final follow-up of the HPTN 071 (PopART) Population Cohort. HIV-1-negative participants at enrollment (n = 492) were included in this analysis, with testing to confirm incident HIV-1 performed in HPTN 071 (PopART). The association of incident HIV-1 infection with FGS (Schistosoma DNA detected by polymerase chain reaction [PCR] in any genital specimen) was assessed with exact Poisson regression. RESULTS: Incident HIV-1 infections were observed in 4.1% (20/492) of participants. Women with FGS were twice as likely to seroconvert as women without FGS but with no statistical evidence for a difference (adjusted rate ratio, 2.16; 95% CI, 0.21-12.30; P = .33). Exploratory analysis suggested an association with HIV-1 acquisition among women with ≥2 positive genital PCR specimens (rate ratio, 6.02; 95% CI, 0.58-34.96; P = .13). CONCLUSIONS: Despite higher HIV seroconversion rates in women with FGS, there was no statistical evidence of association, possibly due to low power. Further longitudinal studies should investigate this association in a setting with higher schistosomiasis endemicity.

Published
2021

24. Association between HIV stigma and antiretroviral therapy adherence among adults living with HIV: baseline findings from the HPTN 071 (PopART) trial in Zambia and South Africa

Author

Jones, Harriet S, Floyd, Sian, Stangl, Anne, Bond, Virginia, Hoddinott, Graeme, Pliakas, Triantafyllos, Bwalya, Justin, Mandla, Nomtha, Moore, Ayana, Donnell, Deborah, Bock, Peter, Fidler, Sarah, Hayes, Richard, Ayles, Helen, Hargreaves, James R, and HPTN 071 (PopART) Study Team

Abstract

OBJECTIVES: Adherence to antiretroviral therapy (ART) leads to viral suppression for people living with HIV (PLHIV) and is critical for both individual health and reducing onward HIV transmission. HIV stigma is a risk factor that can undermine adherence. We explored the association between HIV stigma and self-reported ART adherence among PLHIV in 21 communities in the HPTN 071 (PopART) trial in Zambia and the Western Cape of South Africa. METHODS: We conducted a cross-sectional analysis of baseline data collected between 2013 and 2015, before the roll-out of trial interventions. Questionnaires were conducted, and consenting participants provided a blood sample for HIV testing. Poor adherence was defined as self-report of not currently taking ART, missing pills over the previous 7 days or stopping treatment in the previous 12 months. Stigma was categorised into three domains: community, health setting and internalised stigma. Multivariable logistic regression was used for analysis. RESULTS: Among 2020 PLHIV self-reporting ever taking ART, 1888 (93%) were included in multivariable analysis. Poor ART adherence was reported by 15.8% (n = 320) of participants, and 25.7% (n = 519) reported experiencing community stigma, 21.5% (n = 434) internalised stigma, and 5.7% (n = 152) health setting stigma. PLHIV who self-reported previous experiences of community and internalised stigma more commonly reported poor ART adherence than those who did not (aOR 1.63, 95% CI 1.21 -2.19, P = 0.001 and aOR 1.31, 95% CI 0.96-1.79, P = 0.09). CONCLUSIONS: HIV stigma was associated with poor ART adherence. Roll-out of universal treatment will see an increasingly high proportion of PLHIV initiated on ART. Addressing HIV stigma could make an important contribution to supporting lifelong ART adherence.

Published
2020

25. Female Genital Schistosomiasis and HIV-1 Incidence in Zambian Women: A Retrospective Cohort Study

Author

Sturt, Amy S, primary, Webb, Emily L, additional, Phiri, Comfort R, additional, Mudenda, Maina, additional, Mapani, Joyce, additional, Kosloff, Barry, additional, Cheeba, Maina, additional, Shanaube, Kwame, additional, Bwalya, Justin, additional, Kjetland, Eyrun F, additional, Francis, Suzanna C, additional, Corstjens, Paul L A M, additional, van Dam, Govert J, additional, van Lieshout, Lisette, additional, Hansingo, Isaiah, additional, Ayles, Helen, additional, Hayes, Richard J, additional, and Bustinduy, Amaya L, additional

Published
2021
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26. Sexually Transmitted Bedfellows: Exquisite Association Between HIV and Herpes Simplex Virus Type 2 in 21 Communities in Southern Africa in the HIV Prevention Trials Network 071 (PopART) Study

Author

Bradley, John, Floyd, Sian, Piwowar-Manning, Estelle, Laeyendecker, Oliver, Young, Alicia, Bell-Mandla, Nomtha, Bwalya, Justin, Bock, Peter, Fidler, Sarah, Ayles, Helen, Hayes, Richard J, and HPTN 071 (PopART) Study Team

Abstract

Background: Human immunodeficiency virus (HIV) and herpes simplex virus type 2 (HSV2) are strongly associated, although mechanisms are not fully understood. An HIV prevention trial allowed reexamination of this association at individual and community levels. Methods: The HIV Prevention Trials Network 071 (PopART) study evaluates a combination prevention intervention in 21 urban communities in Zambia and South Africa. To measure impact on HIV infection incidence, a cohort of approximately 2000 adults (age range, 18-44 years) was selected randomly from each community. Baseline data on sociodemographic characteristics, behavior, and HIV/HSV2 serologic findings were used to examine the association between HIV and HSV2. At the community level, HIV prevalence was plotted against HSV2 prevalence. Results: A total of 38691 adults participated. HSV2 prevalence among women and men was 50% and 22%, respectively, in Zambia and 60% and 27%, respectively, in South Africa. Estimated HSV2 infection incidence among those aged 18-24 years was 8.06 cases/100 person-years (95% confidence interval [CI], 6.76-9.35) and 1.76 cases/100 person-years (95% CI, 1.30-2.22) among women and men, respectively. A 6-fold higher odds of HIV infection was seen in HSV2-infected individuals in both sexes, after adjustment for confounders (odds ratio, 6.66 [95% CI, 6.07-7.31] among women and 6.57 [95% CI, 5.56-7.77] among men). At the community-level, there was a strong linear relationship between HIV and HSV2 prevalence (ρ = 0.92; P < .001). Conclusions: There was an exquisite association between these 2 infections, at the individual and community levels, likely due in part to a powerful cofactor effect of HSV2 on HIV transmission. HSV2 control could contribute to HIV prevention.

Published
2018

27. Effect of Universal Testing and Treatment on HIV Incidence — HPTN 071 (PopART)

Author

Hayes, Richard J., primary, Donnell, Deborah, additional, Floyd, Sian, additional, Mandla, Nomtha, additional, Bwalya, Justin, additional, Sabapathy, Kalpana, additional, Yang, Blia, additional, Phiri, Mwelwa, additional, Schaap, Ab, additional, Eshleman, Susan H., additional, Piwowar-Manning, Estelle, additional, Kosloff, Barry, additional, James, Anelet, additional, Skalland, Timothy, additional, Wilson, Ethan, additional, Emel, Lynda, additional, Macleod, David, additional, Dunbar, Rory, additional, Simwinga, Musonda, additional, Makola, Nozizwe, additional, Bond, Virginia, additional, Hoddinott, Graeme, additional, Moore, Ayana, additional, Griffith, Sam, additional, Deshmane Sista, Nirupama, additional, Vermund, Sten H., additional, El-Sadr, Wafaa, additional, Burns, David N., additional, Hargreaves, James R., additional, Hauck, Katharina, additional, Fraser, Christophe, additional, Shanaube, Kwame, additional, Bock, Peter, additional, Beyers, Nulda, additional, Ayles, Helen, additional, and Fidler, Sarah, additional

Published
2019
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28. Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa: a cross-sectional baseline survey of the HPTN 071 (PopART) trial

Author

Thomas, Ranjeeta, primary, Burger, Ronelle, additional, Harper, Abigail, additional, Kanema, Sarah, additional, Mwenge, Lawrence, additional, Vanqa, Nosivuyile, additional, Bell-Mandla, Nomtha, additional, Smith, Peter C, additional, Floyd, Sian, additional, Bock, Peter, additional, Ayles, Helen, additional, Beyers, Nulda, additional, Donnell, Deborah, additional, Fidler, Sarah, additional, Hayes, Richard, additional, Hauck, Katharina, additional, Hargreaves, James, additional, Watson-Jones, Deborah, additional, Godfrey-Faussett, Peter, additional, Cori, Anne, additional, Pickles, Mike, additional, Mandla, Nomtha, additional, Yang, Blia, additional, James, Anelet, additional, Vermaak, Redwaan, additional, Makola, Nozizwe, additional, Hoddinott, Graeme, additional, Naidoo, Vikesh, additional, Bond, Virginia, additional, Simwinga, Musonda, additional, Mwinga, Alwyn, additional, Kosloff, Barry, additional, Limbada, Mohammed, additional, Bwalya, Justin, additional, Ngulube, Chepela, additional, Fraser, Christophe, additional, Eshleman, Susan, additional, Agyei, Yaw, additional, Cummings, Vanessa, additional, Catalano, Denni, additional, Emel, Lynda, additional, Bunts, Lisa, additional, Noble, Heather, additional, Burns, David, additional, Kouda, Alain, additional, Sista, Niru, additional, Moore, Ayana, additional, White, Rhonda, additional, Headen, Tanette, additional, Miller, Eric, additional, Hinson, Kathy, additional, Vermund, Sten, additional, Barnes, Mark, additional, Horn, Lyn, additional, Mwango, Albert, additional, Baldwin, Megan, additional, Wolf, Shauna, additional, and Hughes, Erin, additional

Published
2017
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29. The effect of universal testing and treatment for HIV on health-related quality of life – an analysis of data from the HPTN 071 (PopART) cluster randomised trial

Author

Davis, Katherine, Pickles, Michael, Gregson, Simon, Hargreaves, James R., Ayles, Helen, Bock, Peter, Pliakas, Triantafyllos, Thomas, Ranjeeta, Ohrnberger, Julius, Bwalya, Justin, Bell-Mandla, Nomtha, Shanaube, Kwame, Probert, William, Hoddinott, Graeme, Bond, Virginia, Hayes, Richard, Fidler, Sarah, Hauck, Katharina, Davis, Katherine, Pickles, Michael, Gregson, Simon, Hargreaves, James R., Ayles, Helen, Bock, Peter, Pliakas, Triantafyllos, Thomas, Ranjeeta, Ohrnberger, Julius, Bwalya, Justin, Bell-Mandla, Nomtha, Shanaube, Kwame, Probert, William, Hoddinott, Graeme, Bond, Virginia, Hayes, Richard, Fidler, Sarah, and Hauck, Katharina

Abstract

Background: HIV treatment has clear Health-Related Quality-of-Life (HRQoL) benefits. However, little is known about how Universal Testing and Treatment (UTT) for HIV affects HRQoL. This study aimed to examine the effect of a combination prevention intervention, including UTT, on HRQoL among People Living with HIV (PLHIV). Methods: Data were from HPTN 071 (PopART), a three-arm cluster randomised controlled trial in 21 communities in Zambia and South Africa (2013–2018). Arm A received the full UTT intervention of door-to-door HIV testing plus access to antiretroviral therapy (ART) regardless of CD4 count, Arm B received the intervention but followed national treatment guidelines (universal ART from 2016), and Arm C received standard care. The intervention effect was measured in a cohort of randomly selected adults, over 36 months. HRQoL scores, and the prevalence of problems in five HRQoL dimensions (mobility, self-care, performing daily activities, pain/discomfort, anxiety/depression) were assessed among all participants using the EuroQol-5-dimensions-5-levels questionnaire (EQ-5D-5L). We compared HRQoL among PLHIV with laboratory confirmed HIV status between arms, using adjusted two-stage cluster-level analyses. Results: At baseline, 7,856 PLHIV provided HRQoL data. At 36 months, the mean HRQoL score was 0.892 (95% confidence interval: 0.887–0.898) in Arm A, 0.886 (0.877–0.894) in Arm B and 0.888 (0.884–0.892) in Arm C. There was no evidence of a difference in HRQoL scores between arms (A vs C, adjusted mean difference: 0.003, -0.001-0.006; B vs C: -0.004, -0.014-0.005). The prevalence of problems with pain/discomfort was lower in Arm A than C (adjusted prevalence ratio: 0.37, 0.14–0.97). There was no evidence of differences for other HRQoL dimensions. Conclusions: The intervention did not change overall HRQoL, suggesting that raising HRQoL among PLHIV might require more than improved testing and treatment. However, PLHIV had fewer problems with pain/discomfort unde

30. Associations between HIV stigma and health-related quality-of-life among people living with HIV: cross-sectional analysis of data from HPTN 071 (PopART)

Author

Hall, Emily, Davis, Katherine, Ohrnberger, Julius, Pickles, Michael, Gregson, Simon, Thomas, Ranjeeta, Hargreaves, James R., Pliakas, Triantafyllos, Bwalya, Justin, Dunbar, Rory, Mainga, Tila, Shanaube, Kwame, Hoddinott, Graeme, Bond, Virginia, Bock, Peter, Ayles, Helen, Stangl, Anne L., Donnell, Deborah, Hayes, Richard, Fidler, Sarah, Hauck, Katharina, Hall, Emily, Davis, Katherine, Ohrnberger, Julius, Pickles, Michael, Gregson, Simon, Thomas, Ranjeeta, Hargreaves, James R., Pliakas, Triantafyllos, Bwalya, Justin, Dunbar, Rory, Mainga, Tila, Shanaube, Kwame, Hoddinott, Graeme, Bond, Virginia, Bock, Peter, Ayles, Helen, Stangl, Anne L., Donnell, Deborah, Hayes, Richard, Fidler, Sarah, and Hauck, Katharina

Abstract

People living with HIV (PLHIV) report lower health-related quality-of-life (HRQoL) than HIV-negative people. HIV stigma may contribute to this. We explored the association between HIV stigma and HRQoL among PLHIV. We used cross-sectional data from 3991 randomly selected PLHIV who were surveyed in 2017–2018 for HPTN 071 (PopART), a cluster randomised trial in Zambia and South Africa. Participants were 18–44 years, had laboratory-confirmed HIV infection, and knew their status. HRQoL was measured using the EuroQol-5-dimensions-5-levels (EQ-5D-5L) questionnaire. Stigma outcomes included: internalised stigma, stigma experienced in the community, and stigma experienced in healthcare settings. Associations were examined using logistic regression. Participants who had experienced community stigma (n = 693/3991) had higher odds of reporting problems in at least one HRQoL domain, compared to those who had not (adjusted odds ratio, aOR: 1.51, 95% confidence interval, 95% Cl: 1.16–1.98, p = 0.002). Having experienced internalised stigma was also associated with reporting problems in at least one HRQoL domain (n = 552/3991, aOR: 1.98, 95% CI: 1.54–2.54, p < 0.001). However, having experienced stigma in a healthcare setting was less common (n = 158/3991) and not associated with HRQoL (aOR: 1.04, 95% CI: 0.68–1.58, p = 0.850). A stronger focus on interventions for internalised stigma and stigma experienced in the community is required.

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