Table 1.
UTT trial design and HIV incidence outcomes in sub‐Saharan Africa
| Trial | BCPP/Ya Tsie | HPTN 071 (PopART) | SEARCH | ANRS 12249 (TasP) | |||||
|---|---|---|---|---|---|---|---|---|---|
| Country | Botswana | South Africa/Zambia | Kenya/Uganda | South Africa | |||||
| Prevalence | 29% | 22% | 4% to 19% | 30% | |||||
| Arm | C | I | C |
I Arm A |
I Arm B |
C | I | C | I |
| Universal testing | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||
| Home, mobile | Home + field (men, youth) | Home + field (men, youth) |
Multi‐dz Fairs/ Home |
Multi‐dz Fairs/ Home |
Home | Home | |||
| Testing frequency | Baseline; ongoing targeted | Ongoing Annual |
Ongoing ~Annual |
Baseline | Annual | 6 monthly | 6 monthly | ||
| Enhanced linkage | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
| Rapid ART Start | ✓ | ✓ | |||||||
| (from 2016) | |||||||||
| Universal Treatment | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |
| (from 2016) | (from 2016) | (from 2016) | (from 2016) | (from 2016) | |||||
| Differentiated ART Delivery | ✓ | ✓ | ✓a | ||||||
| (Zambiac) | (Zambiac) | ||||||||
| Population viral suppression | |||||||||
| At start | 75% | 70% | 52% |
57%b 74%b +17b |
42% | 42% | 26% | 23% | |
| At end | 83% | 88% | 68% | 68% | 79% | 45% | 46% | ||
| Difference | +8 | +18 | +16 | +26 | +37 | +19 | +23 | ||
| HIV Incidence | |||||||||
| Annual Incidence for 100 person‐years | 0.92 | 0.59 | 1.55 | 1.24b | 0.27 | 0.25 | 2.27 | 2.11 | |
|
Reduction (I vs. C) |
31% Reduction | 20% Reduction |
Not significant, 32% reduction in intervention arm between years 1 & 3 |
Not significant | |||||
Additional details are previously published 11. C, control; I, Intervention; UTT, Universal test and treat.
a
Patient‐centered care, including “friendly provider service,” flexible clinic hours, tiered tracking, and provider access via mobile phone 12
b
both intervention arms were pooled for HPTN 071 (PopART) for population viral suppression and HIV incidence
c
option for ART delivery in community adherence groups.