Browsing by Author "Dilorenzo M"

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    Impact of Universal Antiretroviral Treatment Eligibility on Rapid Treatment Initiation Among Young Adolescents with Human Immunodeficiency Virus in Sub-Saharan Africa.
    (2020-Aug-04) Tymejczyk O; Brazier E; Wools-Kaloustian K; Davies MA; Dilorenzo M; Edmonds A; Vreeman R; Bolton C; Twizere C; Okoko N; Phiri S; Nakigozi G; Lelo P; von Groote P; Sohn AH; Nash D; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.; Institute for Implementation Science in Population Health, City University of New York, New York, NY, USA.; Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.; Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.; Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Kalembelembe Pediatric Hospital, Kinshasa, Democratic Republic of the Congo.; TREAT Asia, amfAR-The Foundation for AIDS Research, Bangkok, Thailand.; Lighthouse Trust, Lilongwe, Malawi.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Rakai Health Sciences Program, Kalisizo, Uganda.; Department of Epidemiology and Biostatistics, School of Public Health, City University of New York, New York, NY, USA.; Centre Hospitalo-Universitaire de Kamenge, Bujumbura, Burundi.; Indiana University School of Medicine, Indianapolis, Indiana, USA.; Boston Medical Center, Boston, Massachusetts, USA.; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    BACKGROUND: Young adolescents with perinatally acquired human immunodeficiency virus (HIV) are at risk for poor care outcomes. We examined whether universal antiretroviral treatment (ART) eligibility policies (Treat All) improved rapid ART initiation after care enrollment among 10-14-year-olds in 7 sub-Saharan African countries. METHODS: Regression discontinuity analysis and data for 6912 patients aged 10-14-years were used to estimate changes in rapid ART initiation (within 30 days of care enrollment) after adoption of Treat All policies in 2 groups of countries: Uganda and Zambia (policy adopted in 2013) and Burundi, Democratic Republic of the Congo, Kenya, Malawi, and Rwanda (policy adopted in 2016). RESULTS: There were immediate increases in rapid ART initiation among young adolescents after national adoption of Treat All. Increases were greater in countries adopting the policy in 2016 than in those adopting it in 2013: 23.4 percentage points (pp) (95% confidence interval, 13.9-32.8) versus 11.2pp (2.5-19.9). However, the rate of increase in rapid ART initiation among 10-14-year-olds rose appreciably in countries with earlier treatment expansions, from 1.5pp per year before Treat All to 7.7pp per year afterward. CONCLUSIONS: Universal ART eligibility has increased rapid treatment initiation among young adolescents enrolling in HIV care. Further research should assess their retention in care and viral suppression under Treat All.