Population-level viremia predicts HIV incidence at the community level across the Universal Testing and Treatment Trials in eastern and southern Africa

Joseph Larmarange, Pamela Bachanas, Timothy Skalland, Laura B Balzer, Collins Iwuji, Sian Floyd, Lisa A Mills, Deenan Pillay, Diane Havlir, Moses R Kamya, Helen Ayles, Kathleen Wirth, François Dabis, Richard Hayes, Maya Petersen and for the UT³C Consortium

PLOS Global Public Health, 2023, vol. 3, issue 7, 1-18

Abstract: Universal HIV testing and treatment (UTT) strategies aim to optimize population-level benefits of antiretroviral treatment. Between 2012 and 2018, four large community randomized trials were conducted in eastern and southern Africa. While their results were broadly consistent showing decreased population-level viremia reduces HIV incidence, it remains unclear how much HIV incidence can be reduced by increasing suppression among people living with HIV (PLHIV). We conducted a pooled analysis across the four UTT trials. Leveraging data from 105 communities in five countries, we evaluated the linear relationship between i) population-level viremia (prevalence of non-suppression–defined as plasma HIV RNA >500 or >400 copies/mL–among all adults, irrespective of HIV status) and HIV incidence; and ii) prevalence of non-suppression among PLHIV and HIV incidence, using parametric g-computation. HIV prevalence, measured in 257 929 persons, varied from 2 to 41% across the communities; prevalence of non-suppression among PLHIV, measured in 31 377 persons, from 3 to 70%; population-level viremia, derived from HIV prevalence and non-suppression, from

Date: 2023
References: Add references at CitEc
Citations:

Downloads: (external link)
https://journals.plos.org/globalpublichealth/artic ... journal.pgph.0002157 (text/html)
https://journals.plos.org/globalpublichealth/artic ... 02157&type=printable (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:plo:pgph00:0002157

DOI: 10.1371/journal.pgph.0002157

Access Statistics for this article

More articles in PLOS Global Public Health from Public Library of Science
Bibliographic data for series maintained by globalpubhealth ().