Effect of the “universal test and treat” policy on the characteristics of persons registering for HIV care and initiating antiretroviral therapy in Uganda
Bibliographic Data
We examined the effect of the Universal Test and Treat (UTT) policy on the characteristics of people living with HIV (PLHIV) at enrolment in HIV care and initiation of antiretroviral therapy (ART) in Uganda using data from 11 nationally representative clinics of The AIDS Support Organisation (TASO). We created two retrospective PLHIV cohorts: pre-UTT (2004–2016), where ART initiation was conditional on CD4 cell count and UTT (2017–2022), where ART was initiated regardless of World Health Organisation (WHO) clinical stage or CD4 cell count. We used a two-sample test of proportions and Wilcoxon rank-sum test to compare proportions and medians, respectively, between the cohorts. A total of 244,693 PLHIV were enrolled at the clinics [pre-UTT, 210,251 (85.9%); UTT, 34,442 (14.1%)]. Compared to the pre-UTT cohort, the UTT cohort had higher proportions of PLHIV that were male ( p 69 years, never married (p 500 cells/μL (47.3% vs. 13.2%, p < 0.001) and WHO stage 1 (31.7% vs. 4.5%, p < 0.001) at ART initiation. Adoption of the UTT policy in Uganda was successful in enrolling previously unreached individuals, such as men and younger and older adults, as well as those with less advanced HIV disease. Future research will investigate the effect of UTT on long-term outcomes such as retention in care, HIV viral suppression, morbidity, and mortality
Antiretroviral therapy · Cohort · Cohort study · Interquartile range · Mann–Whitney U test · Retrospective cohort study · Viral load · Wilcoxon signed-rank test · HIV Research and Treatment · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Immunology · Internal Medicine
| Citations per year | 1.5 |
|---|---|
| Citation span | 2024 - 2026 (3) |
| Highly cited | No |