Recent Publications

Bridging the Efficacy–Effectiveness Gap in HIV Programs: Lessons From Economics

Background: Bridging the efficacy–effectiveness gap in HIV prevention and treatment requires policies that account for human behavior. Setting: Worldwide. Methods: We conducted a narrative review of the literature on HIV in the field of economics, identified common themes within the literature, and identified lessons for implementation science. Results: The reviewed studies illustrate how behaviors are shaped by perceived costs and benefits across a wide range of health and nonhealth 

Time to strengthen HIV treatment and prevention for youth

In The Lancet HIV, Mhairi Maskew and colleagues1 use data from a large national laboratory database in South Africa to examine trends in access to public sector HIV treatment programmes by children and adolescents aged 1–19 years between 2005 and 2016. The authors should be congratulated for highlighting important findings using national data in this often underexamined population, information that is needed to mount a national response. The authors report a ten times increase in the number 

Targeted HCV core antigen monitoring among HIV-positive men who have sex with men is cost-saving

Introduction: The World Health Organization declared the goal of hepatitis C virus (HC V) elimination by 2030. Micro-elimination, which is the reduction of incidence to zero in targeted populations, is less complex and costly and may be the first step to prove whether elimination is feasible. A suitable target group is HI V-positive men who have sex with men (MSM) because of their high-risk behavior and high incidence rates. Moreover, HC V monitoring is integrated in HI V care. The current HC V 

Effective public-private partnerships for sustainable antiretroviral therapy: outcomes of the Right to Care health services GP down-referral program

The recently increased access to antiretroviral therapy (ART) in South Africa has placed additional strain on human and infrastructure resources of the public health sector. Capacity from private-sector General Practitioners (GPs) could be leveraged to ease the current burden on the public health sector. Methods: We conducted a retrospective record review of routine electronic medical record data on a systematic sample of HIV-infected adults (≥18 years old) initiated on ART at a tertiary 

A Profile of the Health of Homeless at an Inner City Primary Health Care Clinic in South Africa

Abstract: People who are homeless present for care with poor health status, influenced by their physical and social environment. Trinity Health Services is an interprofessional student-run clinic providing free health care to the inner city homeless of Johannesburg, South Africa. This descriptive survey profiled the disease conditions of the homeless through a retrospective review of patient files, documented on a predesigned case report form. The data were analyzed using descriptive 

Differentiated models of service delivery (DSD) for antiretroviral treatment of HIV in subSaharan Africa: A review of the gray literature as of June 2019 AMBIT Project Report Number 03

To achieve global targets for the treatment and prevention of HIV, most high prevalence countries are working towards scaling up alternative service delivery approaches, or differentiated service delivery (DSD) models. DSD models aim to achieve a number of potential benefits to both providers and patients, including better clinical outcomes, greater patient satisfaction, lower cost, and more efficient and convenient service delivery. To date, most DSD model development and implementation has 

Differentiated HIV care in South Africa: the effect of fast-track treatment initiation counselling on ART initiation and viral suppression as partial results of an impact evaluation on the impact of a package of services to improve HIV treatment adherence

Introduction: In response to suboptimal adherence and retention, South Africa’s National Department of Health developed and implemented National Adherence Guidelines for Chronic Diseases. We evaluated the effect of a package of adherence interventions beginning in January 2016 and report on the impact of Fast-Track Treatment Initiation Counselling (FTIC) on ART initiation, adherence and retention. Methods: We conducted a cluster-randomized mixed-methods evaluation in 4 provinces at 12 

THE SLATE ALGORITHM FOR SAME-DAY HIV TREATMENT INITIATION: RESULTS OF THE SLATE TRIAL IN SOUTH AFRICA AND KENYA

The World Health Organization recommends "sameday" initiation of antiretroviral therapy (ART) for HIV patients eligible and ready1. This recommendation has been adopted by both South Africa2 and Kenya3. Identifying efficient, safe, and feasible procedures for determining same-day eligibility and readiness is now a priority. The WHO guidelines cited evidence from clinical trials suggesting that offering treatment to patients at their first clinical encounter has the potential to increase 

MAKING BUDGETING WORK: REFLECTIONS FROM THE FINANCIAL CAPACITY BUILDING FOR PROVINCES (FINCAP) PROJECT IN SOUTH AFRICA

The Financial Capacity Building for Provinces (FINCAP) project, run in partnership by the Centre for Economic Governance and Accountability in Africa (CEGAA) and the Health Economics and Epidemiology Research Office (HE2RO), focuses on providing capacity building and technical support to HIV, STI and TB (HAST) programme and finance managers in provincial departments of health in South Africa. The intervention was designed to improve budget planning, costing, expenditure tracking and reporting 

When donor funding leaves: an interrupted time‑series analysis of the impact of integrating direct HIV care and treatment into public health services in a region of Johannesburg

The paper uses an interrupted time series analysis to outline the impact on ART and other services at three primary health care (PHC) clinics in one region of Johannesburg after removal of PEPFAR funding for a co-located ART clinic and integration of HIV treatment into PHC. The three clinics fared differently after PEPFAR funding was removed, but overall, in this study, integration of ART with PHC services did not result in large-scale reductions in overall service delivery. One facility did 

First International Post-Tuberculosis Symposium

The World Health Organisation (WHO) estimates that approximately 54 million people survived TB between 2000 and 2017 alone. There is increasing evidence of long term respiratory complications following TB in a proportion of these patients, preventing them from returning to their normal lives. Patients can suffer from airflow obstruction, restrictive and fibrotic defects, bronchiectasis and aspergillomas amongst other conditions. With chronic obstructive pulmonary disease (COPD) being the 

Adolescent HIV treatment in South Africa’s national HIV programme: a retrospective cohort study

The number of South African adolescents receiving HIV care and treatment in South Africa is growing. By use of routinely collected laboratory data from South Africa’s National HIV Programme, we aimed to quantify the numbers of adolescents accessing HIV care and treatment over time, characterise the role of perinatal infection in these trends, and estimate proportions of adolescents seeking HIV care and antiretroviral therapy (ART) in South Africa’s public sector. Methods: We did a