DQRJ52CL
type: UserItem
resource: The impact of population dynamics on the population HIV care cascade: results from the ANRS 12249 Treatment as Prevention trial in rural KwaZulu-Natal (South Africa)
access date: 2018-07-20 06:46:46
repository: Wiley Online Library
rights: © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.
tagged: AutoTag
  label: Cross-sectional cascade
tagged: AutoTag
  label: HIV care continuum
tagged: AutoTag
  label: Migration
tagged: AutoTag
  label: Population dynamics
tagged: AutoTag
  label: Public health
tagged: AutoTag
  label: Rural South Africa
tagged: AutoTag
  label: Structural drivers

The impact of population dynamics on the population HIV care cascade: results from the ANRS 12249 Treatment as Prevention trial in rural KwaZulu-Natal (South Africa)
type: AcademicArticle
abstract: Introduction The universal test and treat strategy (UTT) was developed to maximize the proportion of all HIV-positive individuals on antiretroviral treatment (ART) and virally suppressed, assuming that it will lead to a reduction in HIV incidence at the population level. The evolution over time of the cross-sectional HIV care cascade is determined by individual longitudinal trajectories through the HIV care continuum and underlying population dynamics. The purpose of this paper is to quantify the contribution of each component of population change (in- and out-migration, HIV seroconversion, ageing into the cohort and definitive exit such as death) on the HIV care cascade in the context of the ANRS 12249 Treatment as Prevention (TasP) cluster-randomized trial, investigating UTT in rural KwaZulu-Natal, South Africa, between 2012 and 2016. Methods HIV test results and information on clinic visits, ART prescriptions, viral load and CD4 count, migration and deaths were used to calculate residency status, HIV status and HIV care status for each individual on a daily basis. Position within the HIV care continuum was considered as a score ranging from 0 (undiagnosed) to 4 (virally suppressed). We compared the cascade score of each individual joining or leaving the population of resident adults living with HIV with the average score of their cluster at the time of entry or exit. Then, we computed the contribution of each entry or exit on the average cascade score and their annualized total contribution, by component of change. Results While the average cascade score increased over time in all clusters, that increase was constrained by population dynamics. Permanent exits and ageing into the people living with HIV cohort had a marginal effect. Both in-migrants and out-migrants were less likely to be retained at each step of the HIV care continuum. However, their overall impact on the cross-sectional cascade was limited as the effect of in- and out-migration balanced each othe…
pages: e25128
doi: 10.1002/jia2.25128
citation key: larmarangeImpactPopulationDynamics2018
short title: The impact of population dynamics on the population HIV care cascade
language: en
creator: Person
author list: Person
is part of: Issue
  date: 2018-07-20
  volume: 21
  issue: S4
  is part of: Journal of the International AIDS Society
    type: Journal
    issn: 1758-2652

Person
given name: Joseph
surname: Larmarange

Person
given name: Mamadou Hassimiou
surname: Diallo

Person
given name: Nuala
surname: McGrath

Person
given name: Collins
surname: Iwuji

Person
given name: Mélanie
surname: Plazy

Person
given name: Rodolphe
surname: Thiébaut

Person
given name: Frank
surname: Tanser

Person
given name: Till
surname: Bärnighausen

Person
given name: Deenan
surname: Pillay

Person
given name: François
surname: Dabis

Person
given name: Joanna
surname: Orne-Gliemann