Science News
from research organizations

Simplified HIV Test and Treat program associated with better coverage and lower mortality

Date:
September 8, 2015
Source:
PLOS
Summary:
A 'Test and Treat' protocol for HIV/AIDS diagnosis and treatment, implemented in two Guangxi, China counties in 2012, was associated with increased engagement in HIV/AIDS care and a 62 percent reduction in mortality among participants, according to a new study. This before-and-after analysis suggests that broader implementation of the program may inexpensively improve outcomes for HIV-positive individuals in China.
Share:
FULL STORY

A "Test and Treat" protocol for HIV/AIDS diagnosis and treatment, implemented in two Guangxi, China counties in 2012, was associated with increased engagement in HIV/AIDS care and a 62% reduction in mortality among participants, according to a study published this week in PLOS Medicine. This before-and-after analysis, conducted by Zunyou Wu from the National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention in Beijing, and colleagues, suggests that broader implementation of the program may inexpensively improve outcomes for HIV-positive individuals in China.

In many countries including China, barriers to diagnosis, linkage to care, and continuation of care still limit effective HIV/AIDS treatment. Wu and colleagues investigated outcomes associated with a simplified "Test and Treat" intervention incorporating same-visit HIV confirmatory testing, pre-ART CD4 baseline testing, pretreatment counseling, and ART eligibility regardless of CD4 count. A total of 1,034 HIV-positive participants were enrolled, 620 before and 414 after program implementation. Following implementation, the number of people receiving CD4 testing within 30 days of HIV confirmation rose from 64% to 97%, and time to ART initiation decreased from around 50 days to 5 days. The proportion of eligible individuals who initiated ART increased from below 52% to above 91%, and mortality rates among eligible participants fell from about 37% to about 13% (all p < 0.001). Wu and colleagues estimated that the cost of each death prevented by the program was about US$235, mostly incurred during the initial year of the intervention.

The pre-post study design, rather than a controlled trial, may limit the accuracy of these findings; in addition, outcomes may not generalize outside China. Nevertheless, these results suggest that a purely structural change can ensure that fewer patients are lost along the continuum of HIV testing and treatment. The authors state, "Our findings provide program-based evidence to support widespread implementation of this intervention in China and to support similar test and treat strategies elsewhere."


Story Source:

Materials provided by PLOS. Note: Content may be edited for style and length.


Journal Reference:

  1. Zunyou Wu, Yan Zhao, Xianmin Ge, Yurong Mao, Zhenzhu Tang, Cynthia X. Shi, Chi Chen, Yong Li, Xuejun Qiu, Guide Nong, Shanhui Huang, Shen Luo, Shaohui Wu, Wenzhen He, Mingjie Zhang, Zhiyong Shen, Xia Jin, Jian Li, Ron Brookmeyer, Roger Detels, Julio Montaner, Yu Wang. Simplified HIV Testing and Treatment in China: Analysis of Mortality Rates Before and After a Structural Intervention. PLOS Medicine, 2015; 12 (9): e1001874 DOI: 10.1371/journal.pmed.1001874

Cite This Page:

PLOS. "Simplified HIV Test and Treat program associated with better coverage and lower mortality." ScienceDaily. ScienceDaily, 8 September 2015. <www.sciencedaily.com/releases/2015/09/150908144134.htm>.
PLOS. (2015, September 8). Simplified HIV Test and Treat program associated with better coverage and lower mortality. ScienceDaily. Retrieved May 23, 2017 from www.sciencedaily.com/releases/2015/09/150908144134.htm
PLOS. "Simplified HIV Test and Treat program associated with better coverage and lower mortality." ScienceDaily. www.sciencedaily.com/releases/2015/09/150908144134.htm (accessed May 23, 2017).

RELATED STORIES