TY - JOUR
T1 - Research priorities to inform “Treat All” policy implementation for people living with HIV in sub-Saharan Africa
T2 - a consensus statement from the International epidemiology Databases to Evaluate AIDS (IeDEA)
AU - the IeDEA Treat All in sub-Saharan Africa Consensus Statement Working Group
AU - Yotebieng, Marcel
AU - Brazier, Ellen
AU - Addison, Diane
AU - Kimmel, April D.
AU - Cornell, Morna
AU - Keiser, Olivia
AU - Parcesepe, Angela M.
AU - Onovo, Amobi
AU - Lancaster, Kathryn E.
AU - Castelnuovo, Barbara
AU - Murnane, Pamela M.
AU - Cohen, Craig R.
AU - Vreeman, Rachel C.
AU - Davies, Mary Ann
AU - Duda, Stephany N.
AU - Yiannoutsos, Constantin T.
AU - Bono, Rose S.
AU - Agler, Robert
AU - Bernard, Charlotte
AU - Syvertsen, Jennifer L.
AU - Sinayobye, Jean d.Amour
AU - Wikramanayake, Radhika
AU - Sohn, Annette H.
AU - von Groote, Per M.
AU - Wandeler, Gilles
AU - Leroy, Valeriane
AU - Williams, Carolyn F.
AU - Wools-Kaloustian, Kara
AU - Nash, Denis
AU - Althoff, Keri
AU - Cohen, Craig R.
AU - Dominguez, Geraldina
AU - Duda, Stephany N.
AU - Freeman, Aimee
AU - Jaquet, Antoine
AU - Kimmel, April D.
AU - Markus, Janne
AU - McKaig, Rosemary
AU - Murnane, Pamela M.
AU - Nsonde, Dominique
AU - Parcesepe, Angela M.
AU - von Groote, Per M.
AU - Vreeman, Rachel C.
AU - Williams, Carolyn F.
AU - Yiannoutsos, Constantin
N1 - Publisher Copyright:
© 2019 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society
PY - 2019/1
Y1 - 2019/1
N2 - Introduction: “Treat All” – the treatment of all people with HIV, irrespective of disease stage or CD4 cell count – represents a paradigm shift in HIV care that has the potential to end AIDS as a public health threat. With accelerating implementation of Treat All in sub-Saharan Africa (SSA), there is a need for a focused agenda and research to identify and inform strategies for promoting timely uptake of HIV treatment, retention in care, and sustained viral suppression and addressing bottlenecks impeding implementation. Methods: The Delphi approach was used to develop consensus around research priorities for Treat All implementation in SSA. Through an iterative process (June 2017 to March 2018), a set of research priorities was collectively formulated and refined by a technical working group and shared for review, deliberation and prioritization by more than 200 researchers, implementation experts, policy/decision-makers, and HIV community representatives in East, Central, Southern and West Africa. Results and discussion: The process resulted in a list of nine research priorities for generating evidence to guide Treat All policies, implementation strategies and monitoring efforts. These priorities highlight the need for increased focus on adolescents, men, and those with mental health and substance use disorders – groups that remain underserved in SSA and for whom more effective testing, linkage and care strategies need to be identified. The priorities also reflect consensus on the need to: (1) generate accurate national and sub-national estimates of the size of key populations and describe those who remain underserved along the HIV-care continuum; (2) characterize the timeliness of HIV care and short- and long-term HIV care continuum outcomes, as well as factors influencing timely achievement of these outcomes; (3) estimate the incidence and prevalence of HIV-drug resistance and regimen switching; and (4) identify cost-effective and affordable service delivery models and strategies to optimize uptake and minimize gaps, disparities, and losses along the HIV-care continuum, particularly among underserved populations. Conclusions: Reflecting consensus among a broad group of experts, researchers, policy- and decision-makers, PLWH, and other stakeholders, the resulting research priorities highlight important evidence gaps that are relevant for ministries of health, funders, normative bodies and research networks.
AB - Introduction: “Treat All” – the treatment of all people with HIV, irrespective of disease stage or CD4 cell count – represents a paradigm shift in HIV care that has the potential to end AIDS as a public health threat. With accelerating implementation of Treat All in sub-Saharan Africa (SSA), there is a need for a focused agenda and research to identify and inform strategies for promoting timely uptake of HIV treatment, retention in care, and sustained viral suppression and addressing bottlenecks impeding implementation. Methods: The Delphi approach was used to develop consensus around research priorities for Treat All implementation in SSA. Through an iterative process (June 2017 to March 2018), a set of research priorities was collectively formulated and refined by a technical working group and shared for review, deliberation and prioritization by more than 200 researchers, implementation experts, policy/decision-makers, and HIV community representatives in East, Central, Southern and West Africa. Results and discussion: The process resulted in a list of nine research priorities for generating evidence to guide Treat All policies, implementation strategies and monitoring efforts. These priorities highlight the need for increased focus on adolescents, men, and those with mental health and substance use disorders – groups that remain underserved in SSA and for whom more effective testing, linkage and care strategies need to be identified. The priorities also reflect consensus on the need to: (1) generate accurate national and sub-national estimates of the size of key populations and describe those who remain underserved along the HIV-care continuum; (2) characterize the timeliness of HIV care and short- and long-term HIV care continuum outcomes, as well as factors influencing timely achievement of these outcomes; (3) estimate the incidence and prevalence of HIV-drug resistance and regimen switching; and (4) identify cost-effective and affordable service delivery models and strategies to optimize uptake and minimize gaps, disparities, and losses along the HIV-care continuum, particularly among underserved populations. Conclusions: Reflecting consensus among a broad group of experts, researchers, policy- and decision-makers, PLWH, and other stakeholders, the resulting research priorities highlight important evidence gaps that are relevant for ministries of health, funders, normative bodies and research networks.
KW - 90-90-90 targets
KW - Treat All
KW - implementation science
KW - sub-Saharan Africa
KW - universal HIV treatment
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U2 - 10.1002/jia2.25218
DO - 10.1002/jia2.25218
M3 - Review article
C2 - 30657644
AN - SCOPUS:85060159901
SN - 1758-2652
VL - 22
JO - Journal of the International AIDS Society
JF - Journal of the International AIDS Society
IS - 1
M1 - e25218
ER -