Abstract:
BACKGROUND:HIV testing is the important entry point for HIV care and prevention service, but uptake of HIV testing and thus coverage of antiretroviral therapy are much lower in older children and adolescents than in adults. We investigated the effect of economic incentives provided to caregivers of children aged 8-17 years on uptake of HIV testing and counselling in Harare, Zimbabwe. METHODS:This randomised controlled trial was nested within a household HIV prevalence survey of children aged 8-17 years in Harare. Households with one or more survey participants whose HIV status was unknown were eligible to participate in the trial. Eligible households were randomly assigned (1:1:1) to either receive no incentive, receive a fixed US$2 incentive, or participate in a lottery for $5 or $10 if the participant presented for HIV testing and counselling at a local primary health-care centre. The survey fieldworkers who enrolled participants were not blinded to trial arm allocation, but the statistician was blinded for analysis of outcome. The primary outcome was the proportion of households in which at least one child had an HIV test within 4 weeks of enrolment. HIV test uptake in the incentivised groups was compared with uptake in the non-incentivised group using logistic regression, adjusting for community and number of children as fixed effects and research assistant as a random effect. All analyses were by intention to treat. The trial is registered with the Pan African Clinical Trials Registry, number PACTR201605001615280. FINDINGS:Between Aug 4, and Dec 18, 2015, 2050 eligible households were enrolled in the prevalence survey. 649 (32%) households were assigned no incentive, 740 (34%) households were assigned a $2 incentive, and 661 (32%) households were assigned to lottery participation. Children were unavailable in 148 households in the no-incentive group, 63 households in the $2 incentive group, and 81 households in the lottery group. 1688 households had at least one child with unknown HIV status and were enrolled into the trial. 22 households had no undiagnosed child, and one household refused consent. The primary outcome of HIV testing was assessed in 472 (28%) households in the no-incentive group, 654 (39%) households in the $2 incentive group, and 562 (33%) households in the lottery group. At least one child was HIV tested in 93 (20%) households in the no-incentive group, in 316 (48%) households in the $2 incentive group (adjusted odds ratio 3·67, 95% CI 2·77-4·85; p<0·0001), and in 223 (40%) of 562 households in the lottery group (2·66, 2·00-3·55; p<0·0001). No adverse events were reported. INTERPRETATION:Fixed incentives and lottery-based incentives increased the uptake of HIV testing by older children and adolescents, a key hard-to-reach population. This strategy would be sustainable in the context of vertical HIV infection as repeated testing would not be necessary until sexual debut. FUNDING:Wellcome Trust.
journal_name
Lancet HIVjournal_title
The lancet. HIVauthors
Kranzer K,Simms V,Bandason T,Dauya E,McHugh G,Munyati S,Chonzi P,Dakshina S,Mujuru H,Weiss HA,Ferrand RAdoi
10.1016/S2352-3018(17)30176-5subject
Has Abstractpub_date
2018-02-01 00:00:00pages
e79-e86issue
2eissn
2405-4704issn
2352-3018pii
S2352-3018(17)30176-5journal_volume
5pub_type
杂志文章,随机对照试验相关文献
Lancet HIV文献大全abstract:BACKGROUND:As pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate and emtricitabine for the prevention of HIV infection is rolled out internationally, strategies to maintain effectiveness and to minimise adverse effects merit consideration. In this study, we aimed to assess reductions in renal function a...
journal_title:The lancet. HIV
pub_type: 临床试验,杂志文章
doi:10.1016/S2352-3018(16)30153-9
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:ADVANCE compared the efficacy and safety of two antiretroviral first-line combinations (dolutegravir combined with emtricitabine and either tenofovir disoproxil fumarate or tenofovir alafenamide), with a third regimen (efavirenz combined with emtricitabine and tenofovir disoproxil fumarate) previously recomm...
journal_title:The lancet. HIV
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2352-3018(20)30241-1
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:As access to antiretroviral therapy (ART) expands, increasing numbers of older patients will start treatment and need specialised long-term care. However, the effect of age in ART programmes in resource-constrained settings is poorly understood. The HIV epidemic is ageing rapidly and South Africa has one of ...
journal_title:The lancet. HIV
pub_type: 杂志文章,多中心研究
doi:10.1016/S2352-3018(15)00113-7
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Simplified regimens with reduced pill burden and fewer side-effects are desirable for people living with HIV. We investigated the efficacy and safety of switching to a single-tablet regimen of darunavir, cobicistat, emtricitabine, and tenofovir alafenamide versus continuing a regimen of boosted protease inhi...
journal_title:The lancet. HIV
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2352-3018(17)30179-0
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Cabotegravir (GSK1265744) is an HIV-1 integrase strand transfer inhibitor with potent antiviral activity and a long half-life when administered by injection that prevented simian-HIV infection upon repeat intrarectal challenge in male macaques. We aimed to assess the safety, tolerability, and pharmacokinetic...
journal_title:The lancet. HIV
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2352-3018(17)30068-1
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:The South African national HIV plan recommends pre-exposure prophylaxis (PrEP) for transgender women, whose HIV prevalence estimates are as high as 25% in sub-Saharan Africa. The aim of this study was to explore PrEP awareness, uptake, and willingness, as well as associated barriers and facilitators, in orde...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(20)30119-3
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Tuberculosis, which is often undiagnosed, is the major cause of death among HIV-positive people. We aimed to test whether the use of a clinical algorithm enabling the initiation of empirical tuberculosis treatment by nurses in primary health-care clinics would reduce mortality compared with standard of care ...
journal_title:The lancet. HIV
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2352-3018(19)30266-8
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:As HIV incidence and mortality continue to increase in eastern Europe and central Asia, particularly among people who inject drugs (PWID), it is crucial to effectively scale-up opioid agonist therapy (OAT), such as methadone or buprenorphine maintenance therapy, to optimise HIV outcomes. With low OAT coverag...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(19)30373-X
更新日期:2020-02-01 00:00:00
abstract::Despite considerable progress in paediatric HIV treatment and timely revision of global policies recommending the use of more effective and tolerable antiretroviral regimens, optimal antiretroviral formulations for infants, children, and adolescents remain limited. The Paediatric Antiretroviral Drug Optimization group...
journal_title:The lancet. HIV
pub_type: 杂志文章,评审
doi:10.1016/S2352-3018(19)30193-6
更新日期:2019-09-01 00:00:00
abstract::The evaluation of immune-based approaches to achieve an antiretroviral therapy free remission of HIV infection requires proven efficacy through antiretroviral therapy interruption placebo-controlled trials. This approach is not without risk to participants and innovative trial designs need to be developed that minimis...
journal_title:The lancet. HIV
pub_type: 杂志文章,评审
doi:10.1016/S2352-3018(19)30082-7
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Incarceration provides an opportunity for engagement in HIV care but is associated with poor HIV treatment outcomes after release. We aimed to assess post-release linkage to HIV care (LTC) and the effect of transitional case management services. METHODS:To create a retrospective cohort of all adults with HI...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(17)30209-6
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Standard approaches to estimation of losses in the HIV cascade of care are typically cross-sectional and do not include the population stages before linkage to clinical care. We used indiviual-level longitudinal cascade data, transition by transition, including population stages, both to identify the health-...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(16)30224-7
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Although antiretroviral regimens containing integrase inhibitors rapidly suppress HIV viral load in non-pregnant adults, few published data from randomised controlled trials have compared the safety and efficacy of any integrase inhibitor to efavirenz when initiated during pregnancy. We compared safety and e...
journal_title:The lancet. HIV
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2352-3018(20)30038-2
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:In high HIV burden settings, maximising the coverage of prevention strategies is crucial to achieving epidemic control. However, little is known about the reach and effect of these strategies in some communities. METHODS:We did a cross-sectional community survey in the adjacent Greater Edendale and Vulindle...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(18)30104-8
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:The HIV epidemic in the USA is a collection of diverse local microepidemics. We aimed to identify optimal combination implementation strategies of evidence-based interventions to reach 90% reduction of incidence in 10 years, in six US cities that comprise 24·1% of people living with HIV in the USA. METHODS:...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(20)30033-3
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Novel strategies are needed to increase retention in and uptake of prevention of mother-to-child HIV transmission (PMTCT) services in sub-Saharan Africa. We aimed to determine whether small, increasing cash payments, which were conditional on attendance at scheduled clinic visits and receipt of proposed serv...
journal_title:The lancet. HIV
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2352-3018(15)00247-7
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Measures of CD4 T-cell count and HIV-1 plasma viral load before antiretroviral therapy are proxies for virulence. Whether these proxies are changing over time has implications for prevention and treatment. The aim of this study was to investigate those trends. METHODS:Data were derived from the Concerted Ac...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(14)00002-2
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Immune Reconstitution Inflammatory Syndrome (IRIS) is a common complication of antiretroviral therapy (ART) in HIV-infected patients. IRIS is associated with an increased risk of hospitalization and death. We ascertained whether CCR5 blockade using maraviroc reduces the risk of IRIS. METHODS:The CADIRIS stu...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(14)70027-X
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:With continued roll-out of antiretroviral therapy (ART) in resource-limited settings, evidence is emerging of increasing levels of transmitted drug-resistant HIV. We aimed to compare the effectiveness and cost-effectiveness of different potential public health responses to substantial levels of transmitted d...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(14)70021-9
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:The burden of HIV in transgender women (transwomen) in Brazil remains unknown. We aimed to estimate HIV prevalence among transwomen in Rio de Janeiro and to identify predictors of newly diagnosed HIV infections. METHODS:We recruited transwomen from Rio de Janeiro, Brazil, by respondent-driven sampling. Elig...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(17)30015-2
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:An intravaginal ring that releases the tenofovir prodrug, tenofovir disoproxil fumarate, provided 100% protection in macaques against simian HIV and was safe in a 14-day clinical trial in sexually abstinent women. We aimed to assess the safety and pharmacokinetics of this intravaginal ring over 90 days in se...
journal_title:The lancet. HIV
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2352-3018(19)30145-6
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Switching from therapy based on a boosted protease inhibitor to bictegravir, emtricitabine, and tenofovir alafenamide could avoid drug interactions and unwanted side-effects in virologically suppressed adults with HIV-1 infection, while maintaining a high barrier to resistance and providing a simplified once...
journal_title:The lancet. HIV
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2352-3018(18)30091-2
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:HIV evolves rapidly and therefore infections with similar genetic sequences are likely linked by recent transmission events. Clusters of related infections can represent subpopulations with high rates of transmission. We describe the implementation of an automated near real-time system to monitor and charact...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(16)00046-1
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:The number of people on antiretroviral therapy (ART) requiring treatment monitoring in low-resource settings is rapidly increasing. Point-of-care (POC) testing for ART monitoring might alleviate burden on centralised laboratories and improve clinical outcomes, but its cost-effectiveness is unknown. METHODS:...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(20)30279-4
更新日期:2020-12-18 00:00:00
abstract::Progress in the development and introduction of paediatric formulations for key infectious diseases is poor in low-income and middle-income countries (LMICs). Although major steps have been made in the scale-up of antiretroviral medicines in LMICs, the development and deployment of formulations for infants and childre...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(18)30005-5
更新日期:2018-05-01 00:00:00
abstract::South Africa intends to include dolutegravir in its first-line antiretroviral therapy (ART) regimen because of cost savings, the drug's high barrier to resistance, and efficacy. However, recent data from Botswana suggest potential teratogenicity of dolutegravir. WHO recommends that non-pregnant women of childbearing a...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(18)30249-2
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:All recent treatment guidelines recommend integrase strand transfer inhibitors (INSTIs) as components of initial HIV therapy. Bictegravir, a novel, once-daily, unboosted INSTI, showed potent activity in a 10 day monotherapy study and has a high in-vitro resistance barrier. On the basis of these results, we d...
journal_title:The lancet. HIV
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2352-3018(17)30016-4
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Universal antiretroviral therapy (ART), as per the 2015 WHO recommendations, might reduce population HIV incidence. We investigated the effect of universal test and treat on HIV acquisition at population level in a high prevalence rural region of South Africa. METHODS:We did a phase 4, open-label, cluster r...
journal_title:The lancet. HIV
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2352-3018(17)30205-9
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Doravirine is a novel non-nucleoside reverse transcriptase inhibitor (NNRTI) with a pharmacokinetic profile supporting once-daily dosing, and potent in-vitro activity against the most common NNRTI-resistant HIV-1 variants. We compared doravirine with ritonavir-boosted darunavir, when both were given with two...
journal_title:The lancet. HIV
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2352-3018(18)30021-3
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Home HIV testing and counselling (HTC) achieves high levels of HIV testing and linkage to care. Periodic home HTC, particularly targeted to those with high HIV viral load, might facilitate expansion of antiretroviral therapy (ART) coverage. We used a mathematical model to assess the effect of periodic home H...
journal_title:The lancet. HIV
pub_type: 杂志文章
doi:10.1016/S2352-3018(16)30009-1
更新日期:2016-06-01 00:00:00