Comparative assessment of five trials of universal HIV testing and treatment in sub‐Saharan Africa

摘要: DESIGN: Universal voluntary HIV counselling and testing followed by prompt initiation of antiretroviral therapy (ART) for all those diagnosed HIV-infected (universal test treat, UTT) is now a global health standard. However, its population-level impact, feasibility cost remain unknown. Five community-based trials have been implemented in sub-Saharan Africa to measure the effects various UTT strategies at population level: BCPP/YaTsie Botswana, MaxART Swaziland, HPTN 071 (PopART) South Zambia, SEARCH Uganda Kenya ANRS 12249 TasP Africa. This report describes contrasts contexts, research methodologies, intervention packages, themes explored, evolution study designs interventions related each these five trials. METHODS: We conducted comparative assessment using data extracted from protocols collected during baseline studies, with additional input investigators. organized differences commonalities across categories: trial designs, adaptations. RESULTS: All performed context generalized epidemics, highly differ their social, demographic, economic, political systems settings. They share common aim assessing impact on epidemic but methodological aspects such as design eligibility criteria populations. In addition universal ART initiation, deliver wide range biomedical, behavioural structural part strategies. The studies explore issues, including uptake rates services individual outcomes. adapted since evolving political, economic public adopting successive national recommendations initiation. CONCLUSIONS: found substantial also between design, conduct multidisciplinary outputs. As empirical literature how may improve efficiency quality care level still scarce, this article provides foundation more collaborative supports evidence-based decision making country internationally.