Research priorities to inform “Treat All” policy implementation for people living with HIV in sub-Saharan Africa: a consensus statement from the International epidemiology Databases to Evaluate AIDS (IeDEA)

the IeDEA Treat All in sub-Saharan Africa Consensus Statement Working Group

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Introduction: “Treat All” – the treatment of all people with HIV, irrespective of disease stage or CD4 cell count – represents a paradigm shift in HIV care that has the potential to end AIDS as a public health threat. With accelerating implementation of Treat All in sub-Saharan Africa (SSA), there is a need for a focused agenda and research to identify and inform strategies for promoting timely uptake of HIV treatment, retention in care, and sustained viral suppression and addressing bottlenecks impeding implementation. Methods: The Delphi approach was used to develop consensus around research priorities for Treat All implementation in SSA. Through an iterative process (June 2017 to March 2018), a set of research priorities was collectively formulated and refined by a technical working group and shared for review, deliberation and prioritization by more than 200 researchers, implementation experts, policy/decision-makers, and HIV community representatives in East, Central, Southern and West Africa. Results and discussion: The process resulted in a list of nine research priorities for generating evidence to guide Treat All policies, implementation strategies and monitoring efforts. These priorities highlight the need for increased focus on adolescents, men, and those with mental health and substance use disorders – groups that remain underserved in SSA and for whom more effective testing, linkage and care strategies need to be identified. The priorities also reflect consensus on the need to: (1) generate accurate national and sub-national estimates of the size of key populations and describe those who remain underserved along the HIV-care continuum; (2) characterize the timeliness of HIV care and short- and long-term HIV care continuum outcomes, as well as factors influencing timely achievement of these outcomes; (3) estimate the incidence and prevalence of HIV-drug resistance and regimen switching; and (4) identify cost-effective and affordable service delivery models and strategies to optimize uptake and minimize gaps, disparities, and losses along the HIV-care continuum, particularly among underserved populations. Conclusions: Reflecting consensus among a broad group of experts, researchers, policy- and decision-makers, PLWH, and other stakeholders, the resulting research priorities highlight important evidence gaps that are relevant for ministries of health, funders, normative bodies and research networks.

Original languageEnglish (US)
Article numbere25218
JournalJournal of the International AIDS Society
Volume22
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Africa South of the Sahara
Consensus
Acquired Immunodeficiency Syndrome
Epidemiology
HIV
Databases
Research
Continuity of Patient Care
Administrative Personnel
Research Personnel
Central Africa
Southern Africa
Eastern Africa
Western Africa
Long-Term Care
Vulnerable Populations
CD4 Lymphocyte Count
Population Density
Drug Resistance
Substance-Related Disorders

Keywords

  • 90-90-90 targets
  • implementation science
  • sub-Saharan Africa
  • Treat All
  • universal HIV treatment

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Research priorities to inform “Treat All” policy implementation for people living with HIV in sub-Saharan Africa : a consensus statement from the International epidemiology Databases to Evaluate AIDS (IeDEA). / the IeDEA Treat All in sub-Saharan Africa Consensus Statement Working Group.

In: Journal of the International AIDS Society, Vol. 22, No. 1, e25218, 01.01.2019.

Research output: Contribution to journalReview article

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title = "Research priorities to inform “Treat All” policy implementation for people living with HIV in sub-Saharan Africa: a consensus statement from the International epidemiology Databases to Evaluate AIDS (IeDEA)",
abstract = "Introduction: “Treat All” – the treatment of all people with HIV, irrespective of disease stage or CD4 cell count – represents a paradigm shift in HIV care that has the potential to end AIDS as a public health threat. With accelerating implementation of Treat All in sub-Saharan Africa (SSA), there is a need for a focused agenda and research to identify and inform strategies for promoting timely uptake of HIV treatment, retention in care, and sustained viral suppression and addressing bottlenecks impeding implementation. Methods: The Delphi approach was used to develop consensus around research priorities for Treat All implementation in SSA. Through an iterative process (June 2017 to March 2018), a set of research priorities was collectively formulated and refined by a technical working group and shared for review, deliberation and prioritization by more than 200 researchers, implementation experts, policy/decision-makers, and HIV community representatives in East, Central, Southern and West Africa. Results and discussion: The process resulted in a list of nine research priorities for generating evidence to guide Treat All policies, implementation strategies and monitoring efforts. These priorities highlight the need for increased focus on adolescents, men, and those with mental health and substance use disorders – groups that remain underserved in SSA and for whom more effective testing, linkage and care strategies need to be identified. The priorities also reflect consensus on the need to: (1) generate accurate national and sub-national estimates of the size of key populations and describe those who remain underserved along the HIV-care continuum; (2) characterize the timeliness of HIV care and short- and long-term HIV care continuum outcomes, as well as factors influencing timely achievement of these outcomes; (3) estimate the incidence and prevalence of HIV-drug resistance and regimen switching; and (4) identify cost-effective and affordable service delivery models and strategies to optimize uptake and minimize gaps, disparities, and losses along the HIV-care continuum, particularly among underserved populations. Conclusions: Reflecting consensus among a broad group of experts, researchers, policy- and decision-makers, PLWH, and other stakeholders, the resulting research priorities highlight important evidence gaps that are relevant for ministries of health, funders, normative bodies and research networks.",
keywords = "90-90-90 targets, implementation science, sub-Saharan Africa, Treat All, universal HIV treatment",
author = "{the IeDEA Treat All in sub-Saharan Africa Consensus Statement Working Group} and Marcel Yotebieng and Ellen Brazier and Diane Addison and Kimmel, {April D.} and Morna Cornell and Olivia Keiser and Parcesepe, {Angela M.} and Amobi Onovo and Lancaster, {Kathryn E.} and Barbara Castelnuovo and Murnane, {Pamela M.} and Cohen, {Craig R.} and Vreeman, {Rachel C.} and Davies, {Mary Ann} and Duda, {Stephany N.} and Yiannoutsos, {Constantin T.} and Bono, {Rose S.} and Robert Agler and Charlotte Bernard and Syvertsen, {Jennifer L.} and Sinayobye, {Jean d.Amour} and Radhika Wikramanayake and Sohn, {Annette H.} and {von Groote}, {Per M.} and Gilles Wandeler and Valeriane Leroy and Williams, {Carolyn F.} and Kara Wools-Kaloustian and Denis Nash and Keri Althoff and Cohen, {Craig R.} and Geraldina Dominguez and Duda, {Stephany N.} and Aimee Freeman and Antoine Jaquet and Kimmel, {April D.} and Lancaster, {Kathryn E.} and Janne Markus and Rosemary McKaig and Murnane, {Pamela M.} and Dominique Nsonde and Parcesepe, {Angela M.} and {von Groote}, {Per M.} and Vreeman, {Rachel C.} and Williams, {Carolyn F.} and Constantin Yiannoutsos",
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TY - JOUR

T1 - Research priorities to inform “Treat All” policy implementation for people living with HIV in sub-Saharan Africa

T2 - a consensus statement from the International epidemiology Databases to Evaluate AIDS (IeDEA)

AU - the IeDEA Treat All in sub-Saharan Africa Consensus Statement Working Group

AU - Yotebieng, Marcel

AU - Brazier, Ellen

AU - Addison, Diane

AU - Kimmel, April D.

AU - Cornell, Morna

AU - Keiser, Olivia

AU - Parcesepe, Angela M.

AU - Onovo, Amobi

AU - Lancaster, Kathryn E.

AU - Castelnuovo, Barbara

AU - Murnane, Pamela M.

AU - Cohen, Craig R.

AU - Vreeman, Rachel C.

AU - Davies, Mary Ann

AU - Duda, Stephany N.

AU - Yiannoutsos, Constantin T.

AU - Bono, Rose S.

AU - Agler, Robert

AU - Bernard, Charlotte

AU - Syvertsen, Jennifer L.

AU - Sinayobye, Jean d.Amour

AU - Wikramanayake, Radhika

AU - Sohn, Annette H.

AU - von Groote, Per M.

AU - Wandeler, Gilles

AU - Leroy, Valeriane

AU - Williams, Carolyn F.

AU - Wools-Kaloustian, Kara

AU - Nash, Denis

AU - Althoff, Keri

AU - Cohen, Craig R.

AU - Dominguez, Geraldina

AU - Duda, Stephany N.

AU - Freeman, Aimee

AU - Jaquet, Antoine

AU - Kimmel, April D.

AU - Lancaster, Kathryn E.

AU - Markus, Janne

AU - McKaig, Rosemary

AU - Murnane, Pamela M.

AU - Nsonde, Dominique

AU - Parcesepe, Angela M.

AU - von Groote, Per M.

AU - Vreeman, Rachel C.

AU - Williams, Carolyn F.

AU - Yiannoutsos, Constantin

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Introduction: “Treat All” – the treatment of all people with HIV, irrespective of disease stage or CD4 cell count – represents a paradigm shift in HIV care that has the potential to end AIDS as a public health threat. With accelerating implementation of Treat All in sub-Saharan Africa (SSA), there is a need for a focused agenda and research to identify and inform strategies for promoting timely uptake of HIV treatment, retention in care, and sustained viral suppression and addressing bottlenecks impeding implementation. Methods: The Delphi approach was used to develop consensus around research priorities for Treat All implementation in SSA. Through an iterative process (June 2017 to March 2018), a set of research priorities was collectively formulated and refined by a technical working group and shared for review, deliberation and prioritization by more than 200 researchers, implementation experts, policy/decision-makers, and HIV community representatives in East, Central, Southern and West Africa. Results and discussion: The process resulted in a list of nine research priorities for generating evidence to guide Treat All policies, implementation strategies and monitoring efforts. These priorities highlight the need for increased focus on adolescents, men, and those with mental health and substance use disorders – groups that remain underserved in SSA and for whom more effective testing, linkage and care strategies need to be identified. The priorities also reflect consensus on the need to: (1) generate accurate national and sub-national estimates of the size of key populations and describe those who remain underserved along the HIV-care continuum; (2) characterize the timeliness of HIV care and short- and long-term HIV care continuum outcomes, as well as factors influencing timely achievement of these outcomes; (3) estimate the incidence and prevalence of HIV-drug resistance and regimen switching; and (4) identify cost-effective and affordable service delivery models and strategies to optimize uptake and minimize gaps, disparities, and losses along the HIV-care continuum, particularly among underserved populations. Conclusions: Reflecting consensus among a broad group of experts, researchers, policy- and decision-makers, PLWH, and other stakeholders, the resulting research priorities highlight important evidence gaps that are relevant for ministries of health, funders, normative bodies and research networks.

AB - Introduction: “Treat All” – the treatment of all people with HIV, irrespective of disease stage or CD4 cell count – represents a paradigm shift in HIV care that has the potential to end AIDS as a public health threat. With accelerating implementation of Treat All in sub-Saharan Africa (SSA), there is a need for a focused agenda and research to identify and inform strategies for promoting timely uptake of HIV treatment, retention in care, and sustained viral suppression and addressing bottlenecks impeding implementation. Methods: The Delphi approach was used to develop consensus around research priorities for Treat All implementation in SSA. Through an iterative process (June 2017 to March 2018), a set of research priorities was collectively formulated and refined by a technical working group and shared for review, deliberation and prioritization by more than 200 researchers, implementation experts, policy/decision-makers, and HIV community representatives in East, Central, Southern and West Africa. Results and discussion: The process resulted in a list of nine research priorities for generating evidence to guide Treat All policies, implementation strategies and monitoring efforts. These priorities highlight the need for increased focus on adolescents, men, and those with mental health and substance use disorders – groups that remain underserved in SSA and for whom more effective testing, linkage and care strategies need to be identified. The priorities also reflect consensus on the need to: (1) generate accurate national and sub-national estimates of the size of key populations and describe those who remain underserved along the HIV-care continuum; (2) characterize the timeliness of HIV care and short- and long-term HIV care continuum outcomes, as well as factors influencing timely achievement of these outcomes; (3) estimate the incidence and prevalence of HIV-drug resistance and regimen switching; and (4) identify cost-effective and affordable service delivery models and strategies to optimize uptake and minimize gaps, disparities, and losses along the HIV-care continuum, particularly among underserved populations. Conclusions: Reflecting consensus among a broad group of experts, researchers, policy- and decision-makers, PLWH, and other stakeholders, the resulting research priorities highlight important evidence gaps that are relevant for ministries of health, funders, normative bodies and research networks.

KW - 90-90-90 targets

KW - implementation science

KW - sub-Saharan Africa

KW - Treat All

KW - universal HIV treatment

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DO - 10.1002/jia2.25218

M3 - Review article

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JO - Journal of the International AIDS Society

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