Table 4:
Percentage with viral load monitoring before and after national Treat-All policy adoption by country.
| Lesotho | Malawi | Mozambique | South Africa | Zambia | Zimbabwe | |
|---|---|---|---|---|---|---|
|
| ||||||
| Patients | 1,309 (100%) | 9,915 (100%) | 7,295 (100%) | 15,616 (100%) | 109,536 (100%) | 5,975 (100%) |
| before Treat-All | 626 (48%) | 6,071 (61%) | 3,421 (47%) | 8,316 (53%) | 56,951 (52%) | 3,349 (56%) |
| after Treat-All | 683 (52%) | 3,844 (39%) | 3,874 (53%) | 7,300 (47%) | 52,585 (48%) | 2,626 (44%) |
|
| ||||||
| Risk difference at threshold* | −1.2 | 0.6 | 2.6 | 4.0 | 0.7 | 0.4 |
| (95% CI) | (−5.4, 3.1) | (−4.7, 6.0) | (−0.5, 5.7) | (−0.9, 8.8) | (−0.9, 2.2) | (−3.2, 4.0) |
| p-value | 0.589 | 0.815 | 0.094 | 0.108 | 0.400 | 0.809 |
| IK bandwidth (days) | 316 | 113 | 123 | 153 | 149 | 310 |
| patients within bandwidth | 576 | 2,519 | 1,365 | 4,225 | 28,068 | 2,981 |
| Treatment Effect Derivative | 0.001 | 0.024 | −0.036 | 0.041 | −0.031 | −0.041 |
| (95% CI) | (−0.021, 0.024) | (−0.061, 0.110) | (−0.077, 0.0048) | (−0.012, 0.095) | (−0.048, −0.013) | (−0.060, −0.024) |
| p-value | 0.893 | 0.581 | 0.083 | 0.130 | 0.001 | <0.001 |
|
| ||||||
| Predicted outcomes at threshold | ||||||
| just before Treat-All | 2.5 | 8.9 | 1.5 | 75.6 | 12.0 | 8.4 |
| (95% CI) | (−1.0, 6.0) | (4.6, 13.2) | (0.2, 2.8) | (72.0, 79.2) | (11.0, 13.1) | (6.1, 10.7) |
| just after Treat-All | 1.3 | 9.5 | 4.1 | 79.6 | 12.7 | 8.8 |
| (95% CI) | (−1.1, 3.8) | (6.4, 12.7) | (1.3, 7.0) | (76.4, 82.7) | (11.6, 13.8) | (6.0, 11.6) |
| relative change | −48.0% | 6.7% | 173.3% | 5.2% | 5.8% | 4.8% |
|
| ||||||
| Slopes before and after Treat-All † | ||||||
| before Treat-All (95% CI) | 0.0 (−0.2, 0.2) | 0.8 (0.7, 0.8) | 0.1 (0.1, 0.2) | 0.2 (−0.0, 0.3) | 0.4 (0.4, 0.4) | 0.4 (0.3, 0.4) |
| after Treat-All (95% CI) | −0.1 (−0.2, 0.0) | 1.4 (1.1, 1.7) | 0.2 (0.1, 0.3) | −0.1 (−0.3, 0.1) | 1.0 (0.9, 1.1) | 0.2 (0.0, 0.4) |
| p-value | 1.000 | 0.030 | 0.034 | <0.001 | 0.012 | 0.069 |
Abbreviation: CI, confidence interval.
Risk differences at the national Treat-All policy adoption threshold are from regression discontinuity analyses using Imbens-Kalyanaraman (IK) bandwidths derived from all data available within two years before and after the threshold to estimate the difference in local linear predictions. The bandwidth defines the area on each side of the threshold where the relationship between antiretroviral therapy (ART) start and viral load monitoring is assumed to be linear in local linear regression models.
Slope comparison is from separate linear regression models comparing the percentage point change per month before and after Treat-All using all data available within two years before and after national Treat-All adoption.