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@article{Probert:2022:10.1016/s2352-3018(22)00259-4,
author = {Probert, WJM and Sauter, R and Pickles, M and Cori, A and Bell-Mandla, NF and Bwalya, J and Abeler-Dörner, L and Bock, P and Donnell, DJ and Floyd, S and Macleod, D and Piwowar-Manning, E and Skalland, T and Shanaube, K and Wilson, E and Yang, B and Ayles, H and Fidler, S and Hayes, RJ and Fraser, C and Hayes, R and Fidler, S and Beyers, N and Ayles, H and Bock, P and El-Sadr, W and Cohen, M and Eshleman, S and Agyei, Y and Piwowar-Manning, E and Bond, V and Hoddinott, G and Donnell, D and Floyd, S and Wilson, E and Emel, L and Noble, H and Macleod, D and Burns, D and Fraser, C and Cori, A and Sista, N and Griffith, S and Moore, A and Headen, T and White, R and Miller, E and Hargreaves, J and Hauck, K and Thomas, R and Limbada, M and Bwalya, J and Pickles, M and Sabapathy, K and Schaap, A and Dunbar, R and Shanaube, K and Yang, B and Simwinga, M and Smith, P and Vermund, S and Mandla, N and Makola, N and van, Deventer A and James, A and Jennings, K and Kruger, J and Phiri, M and Koslof},
doi = {10.1016/s2352-3018(22)00259-4},
journal = {The Lancet HIV},
pages = {e771--e780},
title = {Projected outcomes of universal testing and treatment in a generalised HIV epidemic in Zambia and South Africa (the HPTN 071 [PopART] trial): a modelling study},
url = {http://dx.doi.org/10.1016/s2352-3018(22)00259-4},
volume = {9},
year = {2022}
}

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TY  - JOUR
AB  - BackgroundThe long-term impact of universal home-based testing and treatment as part of universal testing and treatment (UTT) on HIV incidence is unknown. We made projections using a detailed individual-based model of the effect of the intervention delivered in the HPTN 071 (PopART) cluster-randomised trial.MethodsIn this modelling study, we fitted an individual-based model to the HIV epidemic and HIV care cascade in 21 high prevalence communities in Zambia and South Africa that were part of the PopART cluster-randomised trial (intervention period Nov 1, 2013, to Dec 31, 2017). The model represents coverage of home-based testing and counselling by age and sex, delivered as part of the trial, antiretroviral therapy (ART) uptake, and any changes in national guidelines on ART eligibility. In PopART, communities were randomly assigned to one of three arms: arm A received the full PopART intervention for all individuals who tested positive for HIV, arm B received the intervention with ART provided in accordance with national guidelines, and arm C received standard of care. We fitted the model to trial data twice using Approximate Bayesian Computation, once before data unblinding and then again after data unblinding. We compared projections of intervention impact with observed effects, and for four different scenarios of UTT up to Jan 1, 2030 in the study communities.FindingsCompared with standard of care, a 51% (95% credible interval 40–60) reduction in HIV incidence is projected if the trial intervention (arms A and B combined) is continued from 2020 to 2030, over and above a declining trend in HIV incidence under standard of care.InterpretationA widespread and continued commitment to UTT via home-based testing and counselling can have a substantial effect on HIV incidence in high prevalence communities.FundingNational Institute of Allergy and Infectious Diseases, US President's Emergency Plan for AIDS Relief, International Initiative for Impact Evaluation, Bill &
AU  - Probert,WJM
AU  - Sauter,R
AU  - Pickles,M
AU  - Cori,A
AU  - Bell-Mandla,NF
AU  - Bwalya,J
AU  - Abeler-Dörner,L
AU  - Bock,P
AU  - Donnell,DJ
AU  - Floyd,S
AU  - Macleod,D
AU  - Piwowar-Manning,E
AU  - Skalland,T
AU  - Shanaube,K
AU  - Wilson,E
AU  - Yang,B
AU  - Ayles,H
AU  - Fidler,S
AU  - Hayes,RJ
AU  - Fraser,C
AU  - Hayes,R
AU  - Fidler,S
AU  - Beyers,N
AU  - Ayles,H
AU  - Bock,P
AU  - El-Sadr,W
AU  - Cohen,M
AU  - Eshleman,S
AU  - Agyei,Y
AU  - Piwowar-Manning,E
AU  - Bond,V
AU  - Hoddinott,G
AU  - Donnell,D
AU  - Floyd,S
AU  - Wilson,E
AU  - Emel,L
AU  - Noble,H
AU  - Macleod,D
AU  - Burns,D
AU  - Fraser,C
AU  - Cori,A
AU  - Sista,N
AU  - Griffith,S
AU  - Moore,A
AU  - Headen,T
AU  - White,R
AU  - Miller,E
AU  - Hargreaves,J
AU  - Hauck,K
AU  - Thomas,R
AU  - Limbada,M
AU  - Bwalya,J
AU  - Pickles,M
AU  - Sabapathy,K
AU  - Schaap,A
AU  - Dunbar,R
AU  - Shanaube,K
AU  - Yang,B
AU  - Simwinga,M
AU  - Smith,P
AU  - Vermund,S
AU  - Mandla,N
AU  - Makola,N
AU  - van,Deventer A
AU  - James,A
AU  - Jennings,K
AU  - Kruger,J
AU  - Phiri,M
AU  - Kosloff,B
AU  - Mwenge,L
AU  - Kanema,S
AU  - Sauter,R
AU  - Probert,W
AU  - Kumar,R
AU  - Sakala,E
AU  - Silumesi,A
AU  - Skalland,T
AU  - Yuhas,K
DO  - 10.1016/s2352-3018(22)00259-4
EP  - 780
PY  - 2022///
SN  - 2352-3018
SP  - 771
TI  - Projected outcomes of universal testing and treatment in a generalised HIV epidemic in Zambia and South Africa (the HPTN 071 [PopART] trial): a modelling study
T2  - The Lancet HIV
UR  - http://dx.doi.org/10.1016/s2352-3018(22)00259-4
UR  - https://www.sciencedirect.com/science/article/pii/S2352301822002594?via%3Dihub
UR  - http://hdl.handle.net/10044/1/100824
VL  - 9
ER  -

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