{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:52:02Z","timestamp":1787014322793,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T00:00:00Z","timestamp":1641945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008374","name":"Center for AIDS Research, Emory University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Viral suppression (VS) is the hallmark of successful antiretroviral therapy (ART) programmes. We sought to compare clinic retention, virological outcomes, drug resistance and mortality between peri\u2010urban and rural settings in South Africa after first\u2010line ART.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Beginning in July 2014, 1000 (500 peri\u2010urban and 500 rural) ART\u2010na\u00efve patients with HIV were enrolled and managed according to local standard of care. Clinic retention, virological suppression, virological failure (VF), genotypic drug resistance and mortality were assessed. The definition of VS was a viral load \u22641000 copies\/ml. Time to event analyses were stratified by site, median age and gender. Kaplan\u2013Meier curves were calculated and graphed with log\u2010rank modelling to compare curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Based on 2741 patient\u2010years of follow\u2010up, retention and mortality did not differ between sites. Among all 1000 participants, 47%, 84% and 91% had achieved VS by 6, 12 and 24\u00a0months, respectively, which was observed earlier in the peri\u2010urban site. At both sites, men aged &lt;\u00a032\u00a0years had the highest proportion of VF (15.5%), while women aged &gt;\u00a032\u00a0years had the lowest, at 7.1% (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.018). Among 55\u00a0genotypes, 42 (76.4%) had at one or more resistance mutations, which did not differ by site. K103N (59%) and M184V (52%) were the most common mutations, followed by V106M and K65R (31% each). Overall, death was infrequent (&lt;\u00a04%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>No significant differences in treatment outcomes between peri\u2010urban and rural clinics were observed. In both settings, young men were especially susceptible to clinic attrition and VF. More effective adherence support for this important demographic group is needed to achieve UNAIDS targets.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.13231","type":"journal-article","created":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T23:37:22Z","timestamp":1642030642000},"page":"727-737","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparing effectiveness of first\u2010line antiretroviral therapy between peri\u2010urban and rural clinics in KwaZulu\u2010Natal, South Africa"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3511-2112","authenticated-orcid":false,"given":"Jaysingh","family":"Brijkumar","sequence":"first","affiliation":[{"name":"University of KwaZulu Natal Nelson R Mandela School of Medicine  Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnathan A.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Emory University Rollins School of Public Health  Atlanta Georgia USA"},{"name":"Emory University School of Medicine  Atlanta Georgia USA"},{"name":"University of Lincoln School of Health and Social Care Lincoln International Institute for Rural Health  Lincoln UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent A.","family":"Johnson","sequence":"additional","affiliation":[{"name":"University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Ordonez","sequence":"additional","affiliation":[{"name":"Emory University Rollins School of Public Health  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Sunpath","sequence":"additional","affiliation":[{"name":"University of KwaZulu Natal Nelson R Mandela School of Medicine  Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitch","family":"Lee","sequence":"additional","affiliation":[{"name":"Emory University Rollins School of Public Health  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew R.","family":"Dudgeon","sequence":"additional","affiliation":[{"name":"Emory University Rollins School of Public Health  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Rautman","sequence":"additional","affiliation":[{"name":"Emory University Rollins School of Public Health  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selvan","family":"Pillay","sequence":"additional","affiliation":[{"name":"University of KwaZulu Natal Nelson R Mandela School of Medicine  Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pravi","family":"Moodley","sequence":"additional","affiliation":[{"name":"University of KwaZulu\u2010Natal School of Laboratory Medicine and Medical Sciences National Health Laboratory Service  Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y. V.","family":"Sun","sequence":"additional","affiliation":[{"name":"Emory University Rollins School of Public Health  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1242-1745","authenticated-orcid":false,"given":"Jos\u00e9","family":"Castillo\u2010Mancilla","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan Z.","family":"Li","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel R.","family":"Kuritzkes","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Y. S.","family":"Moosa","sequence":"additional","affiliation":[{"name":"University of KwaZulu Natal Nelson R Mandela School of Medicine  Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent Charles","family":"Marconi","sequence":"additional","affiliation":[{"name":"Emory University Rollins School of Public Health  Atlanta Georgia USA"},{"name":"Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Emory Vaccine Center  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,12]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"UNAIDS.90\u201390\u201390 \u2010 An ambitious treatment target to help end the AIDS epidemic [Internet]. 2017https:\/\/www.unaids.org\/en\/resources\/documents\/2017\/90\u201090\u201090. Accessed December 8 2020."},{"key":"e_1_2_9_3_1","unstructured":"Universal Test and Treat [Internet]. 2016.http:\/\/www.kznhealth.gov.za\/test_treat.htm. Accessed February 5 2021."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1600693"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.21167"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis207"},{"key":"e_1_2_9_7_1","unstructured":"KwaZulu\u2010Natal At A Glance [Internet]. Durban ZA: University of Kwzulu\u2010Natal.http:\/\/mepi.ukzn.ac.za\/OtherInfo\/KZN.aspx. 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