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@article{Hayes:2019:10.1056/NEJMoa1814556,
author = {Hayes, RJ and Donnell, D and Floyd, S and Mandla, N and Bwalya, J and Sabapathy, K and Yang, B and Phiri, M and Schaap, A and Eshleman, SH and Piwowar-Manning, E and Kosloff, B and James, A and Skalland, T and Wilson, E and Emel, L and Macleod, D and Dunbar, R and Simwinga, M and Makola, N and Bond, V and Hoddinott, G and Moore, A and Griffith, S and Deshmane, Sista N and Vermund, SH and El-Sadr, W and Burns, DN and Hargreaves, JR and Hauck, K and Fraser, C and Shanaube, K and Bock, P and Beyers, N and Ayles, H and Fidler, S and HPTN, 071 PopART Study Team},
doi = {10.1056/NEJMoa1814556},
journal = {New England Journal of Medicine},
pages = {207--218},
title = {Effect of universal testing and treatment on HIV incidence - HPTN 071 (PopART).},
url = {http://dx.doi.org/10.1056/NEJMoa1814556},
volume = {381},
year = {2019}
}

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TY  - JOUR
AB  - BACKGROUND: A universal testing and treatment strategy is a potential approach to reduce the incidence of human immunodeficiency virus (HIV) infection, yet previous trial results are inconsistent. METHODS: In the HPTN 071 (PopART) community-randomized trial conducted from 2013 through 2018, we randomly assigned 21 communities in Zambia and South Africa (total population, approximately 1 million) to group A (combination prevention intervention with universal antiretroviral therapy [ART]), group B (the prevention intervention with ART provided according to local guidelines [universal since 2016]), or group C (standard care). The prevention intervention included home-based HIV testing delivered by community workers, who also supported linkage to HIV care and ART adherence. The primary outcome, HIV incidence between months 12 and 36, was measured in a population cohort of approximately 2000 randomly sampled adults (18 to 44 years of age) per community. Viral suppression (<400 copies of HIV RNA per milliliter) was assessed in all HIV-positive participants at 24 months. RESULTS: The population cohort included 48,301 participants. Baseline HIV prevalence was 21% or 22% in each group. Between months 12 and 36, a total of 553 new HIV infections were observed during 39,702 person-years (1.4 per 100 person-years; women, 1.7; men, 0.8). The adjusted rate ratio for group A as compared with group C was 0.93 (95% confidence interval [CI], 0.74 to 1.18; P = 0.51) and for group B as compared with group C was 0.70 (95% CI, 0.55 to 0.88; P = 0.006). The percentage of HIV-positive participants with viral suppression at 24 months was 71.9% in group A, 67.5% in group B, and 60.2% in group C. The estimated percentage of HIV-positive adults in the community who were receiving ART at 36 months was 81% in group A and 80% in group B. CONCLUSIONS: A combination prevention intervention with ART provided according to local guidelines resulted in a 30% lower inciden
AU  - Hayes,RJ
AU  - Donnell,D
AU  - Floyd,S
AU  - Mandla,N
AU  - Bwalya,J
AU  - Sabapathy,K
AU  - Yang,B
AU  - Phiri,M
AU  - Schaap,A
AU  - Eshleman,SH
AU  - Piwowar-Manning,E
AU  - Kosloff,B
AU  - James,A
AU  - Skalland,T
AU  - Wilson,E
AU  - Emel,L
AU  - Macleod,D
AU  - Dunbar,R
AU  - Simwinga,M
AU  - Makola,N
AU  - Bond,V
AU  - Hoddinott,G
AU  - Moore,A
AU  - Griffith,S
AU  - Deshmane,Sista N
AU  - Vermund,SH
AU  - El-Sadr,W
AU  - Burns,DN
AU  - Hargreaves,JR
AU  - Hauck,K
AU  - Fraser,C
AU  - Shanaube,K
AU  - Bock,P
AU  - Beyers,N
AU  - Ayles,H
AU  - Fidler,S
AU  - HPTN,071 PopART Study Team
DO  - 10.1056/NEJMoa1814556
EP  - 218
PY  - 2019///
SN  - 0028-4793
SP  - 207
TI  - Effect of universal testing and treatment on HIV incidence - HPTN 071 (PopART).
T2  - New England Journal of Medicine
UR  - http://dx.doi.org/10.1056/NEJMoa1814556
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31314965
UR  - https://www.nejm.org/doi/10.1056/NEJMoa1814556
UR  - http://hdl.handle.net/10044/1/72186
VL  - 381
ER  -

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