Getting to 90 –90–90: Experiences from the MaxART Early Access to ART for All (EAAA) Trial in Eswatini

AbstractPurpose of ReviewThe MaxART Consortium —led by the Eswatini Ministry of Health—implemented multiple interventions between 2012 and 2017 to achieve UNAIDS 90–90–90 targets. We summarize key findings from community outreach strategies in support of the first 90 goal, and from the Early Access to ART for All (EAAA) trial on the impl ementation of a “Treat All” strategy to achieve the second and third 90 goals within a government-managed public health system.Recent FindingsThe MaxART Consortium demonstrated that “Fast Track,” a problem-solving approach, was effective at increasing testing coverage in the community. Compared with baseline data at 3 months prior to the start of the Fast Track, there was a 273% proportional increase in HIV tests conducted among adolescent males, adolescent females, and ad ult men, and 722% over baseline for adolescent males. The MaxART EAAA trial further showed that implementation of the Treat All policy was associated with significant two-fold shorter time from enrollment into care to ART initiation than under the standard CD4+ cell threshold-based treatment guideli nes. Finally, through the MaxART trial, Eswatini was able to identify areas for further investment, including addressing the system-side barriers to routine viral load monitoring, and designing and implementing innovative community-based approaches to reach individuals who were not more routinely ac cessing HIV testing and counseling services.SummaryAs low- and ...
Source: Current HIV/AIDS Reports - Category: Infectious Diseases Source Type: research