{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T22:07:37Z","timestamp":1784585257800,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,9,13]],"date-time":"2019-09-13T00:00:00Z","timestamp":1568332800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1136158 to Boston University"],"award-info":[{"award-number":["OPP1136158 to Boston University"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Many African countries have had at least two years\u2019 experience with universal treatment eligibility for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>. The literature contains few descriptions, though, of populations starting treatment since adoption of universal eligibility. Using baseline data from a clinical trial of same\u2010day <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> initiation, we describe the populations presenting for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing or care at study clinics in Kenya and South Africa in 2017\u201018, during the era of same\u2010day initiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Simplified Algorithm for Treatment Eligibility (<jats:styled-content style=\"fixed-case\">SLATE<\/jats:styled-content>) trials in Kenya (<jats:styled-content style=\"fixed-case\">SLATE<\/jats:styled-content> I) and South Africa (<jats:styled-content style=\"fixed-case\">SLATE II<\/jats:styled-content>) were multicenter, non\u2010blinded, individually randomized, pragmatic trials evaluating simple, standardized algorithms to determine eligibility for same\u2010day initiation of <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> without relying on laboratory results, point of care tests or multiple clinic visits. In Kenya, enrolment occurred during July 2017 to April 2018. In South Africa, enrolment occurred during March to September 2018. We describe demographic, socioeconomic and clinical characteristics of patients randomized to the same\u2010day initiation arm for both studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results and Discussion<\/jats:title><jats:p>A total of 240 and 296 participants were enrolled in Kenya and South Africa. The majority were female (59% and 64% respectively), with a median age of 35\u00a0years. In both countries, most subjects were newly diagnosed with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> on the day of enrolment (62%, 55%), believed they already had adequate knowledge to begin <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> (78%, 68%), and preferred to start <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> immediately (same\u2010day) (98% in both countries). About 40% of all patients had at least one symptom related to tuberculosis (cough, fever, night sweats, weight loss) and\/or cryptococcal meningitis (continuous headache). More than a third of patients (37%, 36%) presented with advanced disease (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4\u00a0&lt;200\u00a0cells\/mm<jats:sup>3<\/jats:sup>), a fifth presented with very advanced disease (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4\u00a0&lt;\u00a0100), and approximately 1 in 20 presented with very advanced disease and were asymptomatic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite &gt;2\u00a0years of universal eligibility for <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> in Kenya and South Africa, in 2017\u20102018 more than half of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive patients presenting at public sector clinics were not yet aware of their status, and more than a third presented for care with advanced <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> disease. These proportions remain similar to those observed before the introduction of universal eligibility.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25358","type":"journal-article","created":{"date-parts":[[2019,9,13]],"date-time":"2019-09-13T13:46:58Z","timestamp":1568382418000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Who is seeking antiretroviral treatment for <scp>HIV<\/scp> now? Characteristics of patients presenting in Kenya and South Africa in 2017\u20102018"],"prefix":"10.1002","volume":"22","author":[{"given":"Alana T","family":"Brennan","sequence":"first","affiliation":[{"name":"Department of Global Health Boston University School of Public Health Boston MA USA"},{"name":"Department of Epidemiology Boston University School of Public Health Boston MA USA"},{"name":"Health Economics and Epidemiology Research Office Department of Internal Medicine School of Clinical Medicine Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mhairi","family":"Maskew","sequence":"additional","affiliation":[{"name":"Health Economics and Epidemiology Research Office Department of Internal Medicine School of Clinical Medicine Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9322-2387","authenticated-orcid":false,"given":"Bruce A","family":"Larson","sequence":"additional","affiliation":[{"name":"Department of Global Health Boston University School of Public Health Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Tsikhutsu","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute\/U.S. Army Medical Research Directorate\u2010Africa Nairobi Kenya"},{"name":"Henry Jackson Foundation MRI Kericho Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Bii","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute\/U.S. Army Medical Research Directorate\u2010Africa Nairobi Kenya"},{"name":"Henry Jackson Foundation MRI Kericho Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lungisile","family":"Vezi","sequence":"additional","affiliation":[{"name":"Health Economics and Epidemiology Research Office Department of Internal Medicine School of Clinical Medicine Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew P","family":"Fox","sequence":"additional","affiliation":[{"name":"Department of Global Health Boston University School of Public Health Boston MA USA"},{"name":"Department of Epidemiology Boston University School of Public Health Boston MA USA"},{"name":"Health Economics and Epidemiology Research Office Department of Internal Medicine School of Clinical Medicine Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem DF","family":"Venter","sequence":"additional","affiliation":[{"name":"Wits Reproductive Health and HIV Institute Department of Internal Medicine School of Clinical Medicine Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2028-4779","authenticated-orcid":false,"given":"Peter","family":"Ehrenkranz","sequence":"additional","affiliation":[{"name":"Bill and Melinda Gates Foundation Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Global Health Boston University School of Public Health Boston MA USA"},{"name":"Health Economics and Epidemiology Research Office Department of Internal Medicine School of Clinical Medicine Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,13]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"World Health Organization.Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection.2016."},{"key":"e_1_2_8_3_1","unstructured":"WHO(World Health Organization).Fact Sheet: WHO HIV Policy Adoption and Implementation Status in Countries.2018:1\u20134."},{"key":"e_1_2_8_4_1","unstructured":"WHO(World Health Organization).Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach.2013."},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016340"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-018-2928-5"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002106"},{"key":"e_1_2_8_8_1","unstructured":"International Monetary Fund.Data Tables Table\u00a02 Exchange Rates [Internet]. 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