Recent Publications

TB economics: A decade of research

This review assess HE2RO's contribution to the body of evidence on the cost of providing services for TB in South Africa and highlights gaps to inform future research efforts. What did we do? We reviewed and summarised abstracts, presentations, and publications from HE2RO authors which estimated the cost of TB services in the South African National TB Control Program and were disseminated between January 2010 and June 

Integration of tuberculosis and mental health care services

Summary The physical, psychological, social and economic burden of TB on the patient before, during and even after TB treatment is significant.  Routine screening and effective management of comorbid depression and anxiety in TB patients should be incorporated into TB programmes using a more holistic approach to TB care. Integrating psycho-socio-economic support interventions can add significant value to TB control through improvements in treatment success rates and reductions in 

How soon should patients be eligible for differentiated service delivery models for antiretroviral treatment?

Attrition from HIV  treatment (ART) is highest during patients' firsts  months after initiation. Although ≥6 months on ART is an eligibility criterion for most differentiated service delivery (DSD) model guidelines, some patients enroll earlier. We used routinely-collected data on DSD models in Zambia to evaluate loss to follow-up (LTFU) comparing patient enrolling in DSD models early vs those who did so later (>6 

“I was scared dating… who would take me with my status?”- Living with HIV in the UTT era in Johannesburg, South Africa

Despite South Africa’s rollout of Universal Test-and-Treat (UTT) in 2016, many people living with HIV (PLHIV) still experience gaps in ART uptake, adherence, and retention. We sought to understand how PLHIV perceive their HIV status in the UTT era, if there are any challenges, and how their experiences differ from individuals diagnosed with HIV at earlier stages of the 

Does differentiated service delivery for HIV treatment change healthcare providers workload? Provider views from Malawi, South Africa, and Zambia

Differentiated service delivery (DSD) models aim to make delivery of HIV treatment more efficient, reduce the burden on healthcare providers, decongest clinics, and improve quality of care and/or increase clinic capacity. Although many countries are implementing DSD models, there is limited evidence on how they affect providers’ 

Talking about Treatment-as-Prevention and U=U: patient needs and health worker perspectives

People who are virally-suppressed cannot transmit HIV sexually. While the science of HIV treatment- as-prevention (TasP) is clear, this message has not been disseminated widely in sub-Saharan Africa, limiting its value in motivating treatment uptake, adherence, and retention HIV care. We sought to understand the TasP communication needs of persons living with HIV (PLHIV) and barriers and facilitators to TasP communication among health care workers in South 

Anticipated stigma among recently diagnosed HIV clients in the UTT era in Johannesburg, South Africa

Anticipated stigma – the fear that HIV diagnosis and status disclosure could have negative social implications – may adversely affect engagement with HIV care and treatment, despite universal eligibility for treatment under universal test-and-treat (UTT). We aimed to determine prevalence and predictors of anticipated stigma among newly HIV diagnosed individuals under the UTT policy in Johannesburg, South 

How do nurses spend their time? A time and motion analysis in the context of differentiated service delivery at primary public healthcare facilities in South Africa

Among other benefits, differentiated service delivery (DSD) models are expected to reduce the time that clinicians spend with established ART clients enrolled in DSD models and thus potentially increase available provider time for non-DSD ART and non-ART clients. The actual use of provider time after DSD model implementation has not been reported. We measured healthcare provider time utilization in the context of DSD model implementation in South