What is already known about this topic? Monitoring prevalence of advanced human immunodeficiency virus (HIV) disease (i.e., CD4+ T-cell count <200 cells/µL) among persons initiating antiretroviral therapy (ART) is important to help understand ART program outcomes, inform HIV prevention strategies, and forecast need for adjunctive therapies. What is added by this report? In an analysis of 694,138 adult ART records from 10 countries, the prevalence of advanced disease at ART initiation during 2004-2015 declined in eight countries. In Mozambique (2004-2014), Namibia (2004-2012), and Haiti (2004-2015), prevalence of advanced disease at ART initiation declined from 73% to 37% (p<0.001), 80% to 41% (p<0.001), and 75% to 34% (p<0.001), respectively. In the remaining seven countries with data available for 2004-2011, significant declines in prevalence of advanced disease were observed in Nigeria, Swaziland, Uganda, Vietnam, and Zimbabwe. What are the implications for public health practice? Declines in the prevalence of advanced disease at ART enrollment over time in most countries are encouraging, but in 2015, approximately a third of new ART patients still initiated ART late. Adoption of World Health Organization-recommended “treat-all” guidelines and strategies to facilitate earlier HIV testing, and treatment are needed. These strategies would help reduce HIV-related mortality and HIV incidence.
ASJC Scopus subject areas
- Health(social science)
- Health Information Management
- Health, Toxicology and Mutagenesis