First trial of “universal test and treat” in a government health system shows benefits

The MaxART study in eSwatini (previously known as Swaziland) provided the world’s first data on the impact of “universal test and treat” (UTT) in a government-run national health system; UTT entails offering antiretroviral treatment to all HIV-positive individuals, regardless of CD4 count. The study evaluated data from 14 health facilities as they transitioned from the current standard of care to UTT.

Velephi Okello of the eSwatini Ministry of Health reported that adopting UTT led to improved health system performance. The likelihood of achieving viral suppression improved dramatically, with 79% of patients achieving viral suppression under UTT compared with just 4% under the current standard of care. Patients under UTT were also 60% more likely to be retained in care.

Abstract: Universal test and treat (UTT) versus standard of care for access to antiretroviral therapy in HIV clients: The MaxART stepped-wedge randomized controlled health systems trial in Swaziland

Session: AIDS 2018 Co-chairs' Choice (Hall 12, Wednesday, 25 July, 11:00-12:30)