Do HIV treatment eligibility expansions crowd out the sickest? Evidence from rural South Africa

By Sheryl A. Kluberg  Matthew Fox  Michael LaValley, Deenan Pillay, Till Barnighausen  Jacob Bor  |  | 

The 2015 WHO recommendation to initiate all HIV patients on antiretroviral therapy (ART) at diagnosis could potentially overextend health systems and crowd out sicker patients, mitigating the policy’s impact. We evaluate whether South Africa’s prior eligibility expansion from CD4 ≤ 200 to CD4 ≤ 350 cells/ll reduced ART uptake in the sickest patients. methods Using data on all patients presenting to the Hlabisa HIV Treatment.

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Tropical Medicine and International Health