MaxART Phase 2: Early Access to ART for All (2014-2017)
In the second phase of the Maximizing ART for better health and zero new HIV infections in Swaziland (MaxART) programme, we put into practice the exciting evidence that early ART has not only individual health benefits, but also contributes to the prevention of HIV transmission.
The three-year Early Access to ART for All implementation study (2014-2017) was introduced to better understand how to scale up immediate access to HIV treatment in Swaziland. While compelling research findings showed that the use of early ART substantially reduces new HIV infections, practical questions remained concerning specific elements of implementation of early treatment for people who are feeling healthy. These questions include whether or not people will seek health services, accept and start treatment, and stay in care. The study was designed to answer these questions.
The study aimed to evaluate the feasibility, acceptability, clinical outcomes, affordability, and scalability of offering ART to all HIV-positive individuals in Swaziland’s government-managed health system regardless of CD4 count or stage of disease.
A strategic mix of multidisciplinary research methodologies was applied. Community participation was an integral part of the research, that consisted of the following elements:
- clinical mentoring
- community mobilisation
- clinical data research
- social science research
- economic evaluation
- incidence modelling
The second phase of the MaxART programme ended in December 2017. Currently, our partners are in the process of analyzing and writing up the research findings. Key findings and their implications will be presented at the AIDS2018 conference in Amsterdam in July 2018.
Relevance for Southern Africa
The evidence generated will inform Swaziland's HIV guidelines and provide valuable insights for the Southern African region about shifting treatment guidelines and the implementation of ‘Treatment as Prevention’. The study also contains a regional and international linking and learning component.