The UNAIDS 90-90-90 targets aim to double the current 19.5 million people on antiretroviral therapy. To meet the targets and further control the HIV epidemic, countries, including those in Eastern and Southern Africa, have adopted Treat All and differentiated care. Those not yet in care, may be the most difficult to reach. Needs of different patient groups may differ and will influence the approach to Treat All. Evidence on programmatic implementation of Treat All is lacking, both on patient and programme level outcomes. Moreover, with the decrease in access to baseline CD4 count the identification of patients with advanced disease is becoming a challenge. We are therefore proposing to conduct a systematic literature review of programmatic implementation of Treat All. In Zimbabwe, where Treat All is implemented nationally, we will conduct studies to describe the effect of Treat All on patient mix, develop a clinical prediction rule to identify patients with a low CD4 count, monitor mortality under Treat All and its predictors, and explore experiences and perceptions on barriers and enablers to care under Treat All. The findings from these studies will inform differentiated approaches to Treat All in order to improve 90-90-90 targets and individual patient outcomes.
|Effective start/end date||1/03/18 → 19/12/22|
IWETO expertise domain