The effect of antiretroviral treatment (ART) eligibility expansions on patient outcomes, including rates of timely ART initiation among those enrolling in care, has not been assessed on a large scale. In addition, it is not known whether ART eligibility expansions may lead to “crowding out” of sicker patients. This study investigated. changes in timely ART initiation (within 6 months) at the original site of HIV care enrollment after ART eligibility expansions among 284,740 adult ART-naïve patients at 171 International Epidemiology Databases to Evaluate AIDS (IeDEA) network sites in 22 countries where national policies expanding ART eligibility were introduced between 2007 and 2015. Half of the sites included in this analysis were from Southern Africa, one-third were from East Africa, and the remainder were from the Asia-Pacific, Central Africa, North America, and South and Central America regions. The detailed findings underscored the potential of ART eligibility expansion to improve the timeliness of ART initiation globally, particularly for young adults.
Citation: Tymejczyk O, Brazier E, Yiannoutsos C, Wools-Kaloustian K, Althoff K, Crabtree-Ramírez B, Van Nguyen K, Zaniewski E, Dabis F, Sinayobye JD, Anderegg N, Ford N, Wikramanayake R, Nash D; IeDEA Collaboration. HIV treatment eligibility expansion and timely antiretroviral treatment initiation following enrollment in HIV care: A metaregression analysis of programmatic data from 22 countries. PLoS Med. 2018 Mar 23;15(3):e1002534. doi: 10.1371. Link to Article>>