A stepped-wedge randomised trial on the impact of early ART initiation on HIV-patients' economic outcomes in Eswatini

Since 2015, the World Health Organisation (WHO) recommends immediate initiation of antiretroviral therapy (ART) for all HIV-positive patients. Epidemiological evidence points to important health benefits of immediate ART initiation; however, the policy’s impact on the economic aspects of patients�...

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Bibliographic Details
Published in:eLife 2020-08, Vol.9
Main Authors: Steinert, Janina Isabel, Khan, Shaukat, Mlambo, Khudzie, Walsh, Fiona J, Mafara, Emma, Lejeune, Charlotte, Wong, Cebele, Hettema, Anita, Ogbuoji, Osondu, Vollmer, Sebastian, De Neve, Jan-Walter, Mazibuko, Sikhathele, Okello, Velephi, Bärnighausen, Till, Geldsetzer, Pascal
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Anti-HIV Agents - administration & dosage
Anti-HIV Agents - therapeutic use
antiretroviral treatment
Economic Status - statistics & numerical data
Employment - statistics & numerical data
Epidemiology and Global Health
Eswatini
Female
health economics
Health Facilities
healthcare expenditures
HIV Infections - drug therapy
HIV Infections - economics
HIV/AIDS
Humans
Male
Medicine
Middle Aged
randomized controlled trial
Time-to-Treatment - statistics & numerical data
Young Adult
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Summary:Since 2015, the World Health Organisation (WHO) recommends immediate initiation of antiretroviral therapy (ART) for all HIV-positive patients. Epidemiological evidence points to important health benefits of immediate ART initiation; however, the policy’s impact on the economic aspects of patients' lives remains unknown. We conducted a stepped-wedge cluster-randomised controlled trial in Eswatini to determine the causal impact of immediate ART initiation on patients’ individual- and household-level economic outcomes. Fourteen healthcare facilities were non-randomly matched into pairs and then randomly allocated to transition from the standard of care (ART eligibility at CD4 counts of
ISSN:2050-084X
2050-084X
DOI:10.7554/eLife.58487