{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:13:09Z","timestamp":1747185189894,"version":"3.40.5"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T00:00:00Z","timestamp":1626912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008196","name":"M\u00e9decins Sans Fronti\u00e8res","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Universal Test and Treat (UTT) strategies are being adopted across sub\u2010Saharan Africa based on clinical benefits to morbidity and mortality and to attain targets of the Joint United Nations Programme on HIV\/AIDS (UNAIDS). Universal Test and Treat is expected to change the client population at clinics, due to more asymptomatic HIV clients initiating antiretroviral therapy (ART). We assessed the impact of UTT on client appointment adherence at 14\u00a0government\u2010managed health facilities in Eswatini's public sector health system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We assessed the impact of UTT on client adherence to appointment schedules from 2014 to 2017 in a stepped\u2010wedge trial. Repeated measures analysis was used to assess adherence to each scheduled appointment (primary definition: presenting for care within 7\u00a0days after the scheduled appointment), adjusting for time, age, sex, stage, marital status, ART status and facility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 3354\u00a0clients (62.1% female; 57.4% &lt;\u00a035\u00a0years), a median (interquartile range) of 10 (6\u201315) appointments were scheduled during follow\u2010up. In a multivariable\u2010adjusted model, appointment adherence was significantly greater in clients who were female [odds ratio (OR) = 1.38, 95% confidence interval (CI): 1.25\u20131.52], older (e.g. 40 to &lt;\u00a050\u00a0years <jats:italic>vs<\/jats:italic>. &lt;\u00a020 years; OR = 1.45, 95% CI: 1.00\u20132.09), married (OR = 1.31, 95% CI: 1.19\u20131.44), had lower WHO stage at study enrolment (1\u20132 <jats:italic>vs<\/jats:italic>. 3\u20134: OR = 1.26, 95% CI: 1.13\u20131.41), and were currently on ART (OR = 3.55, 95% CI: 2.62\u20134.82). However, UTT strategy was not significantly associated with client adherence to scheduled appointments (OR = 1.02, 95% CI: 0.72\u20131.45).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite transitioning to UTT, there was no change in visit adherence, a reassuring finding given the large volume of clients currently being initiated at earlier stages of HIV.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13144","type":"journal-article","created":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T19:14:51Z","timestamp":1626981291000},"page":"854-859","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal analysis of client appointment adherence under Universal Test and Treat strategy: A stepped\u2010wedge trial"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1939-1307","authenticated-orcid":false,"given":"Caroline E.","family":"Boeke","sequence":"first","affiliation":[{"name":"Clinton Health Access Initiative Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7247-4190","authenticated-orcid":false,"given":"Shaukat","family":"Khan","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative Mbabane Eswatini"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2282-1005","authenticated-orcid":false,"given":"Fiona J.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Lejeune","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative Mbabane Eswatini"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Hettema","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative Mbabane Eswatini"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4006-4650","authenticated-orcid":false,"given":"Donna","family":"Spiegelman","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Velephi","family":"Okello","sequence":"additional","affiliation":[{"name":"Ministry of Health Mbabane Eswatini"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4182-4212","authenticated-orcid":false,"given":"Till","family":"B\u00e4rnighausen","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health Boston MA USA"},{"name":"Heidelberg Institute of Global Health University of Heidelberg Heidelberg Germany"},{"name":"Africa Health Research Institute (AHRI) Durban South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,7,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu603"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540120500101658"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25610"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25120"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002392"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001250"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000008055"},{"issue":"47","key":"e_1_2_9_9_1","article-title":"Differences between HIV\u2010infected men and women in antiretroviral therapy outcomes \u2010 six African countries, 2004\u20102012","volume":"62","author":"Prevention CfDCa","year":"2013","journal-title":"Morb Mortal Wkly Rep"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2011.555743"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-867"},{"issue":"8","key":"e_1_2_9_12_1","first-page":"399","article-title":"Factors related to attrition in a cohort study of HIV in Malawi","volume":"86","author":"Obasanjo OO","year":"2009","journal-title":"East Afr Med J"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.5588\/pha.14.0073"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jana.2007.03.002"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1006\/pmed.2001.0917"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0184591"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-13-242"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-011-9996-9"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2016.1214674"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-012-0367-y"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.13144","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.13144","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.13144","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T07:27:52Z","timestamp":1693294072000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.13144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,22]]},"references-count":19,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1111\/hiv.13144"],"URL":"https:\/\/doi.org\/10.1111\/hiv.13144","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"type":"print","value":"1464-2662"},{"type":"electronic","value":"1468-1293"}],"subject":[],"published":{"date-parts":[[2021,7,22]]},"assertion":[{"value":"2021-06-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}