MaxART Phase 2: Early Access to ART for All
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) is introduced to better understand how to scale up immediate access to HIV treatment in Swaziland. While compelling research findings show that the use of early ART substantially reduces new HIV infections, practical questions remain 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 is designed to answer these questions.
The study will 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. The project expects to enrol and follow up 4,353 clients not yet on ART, among whom 2,376 with newly diagnosed HIV infection.
A strategic mix of multidisciplinary research methodologies will be applied and community participation is an integral part of this implementation research:
- clinical mentoring
- community mobilisation
- clinical data research
- social science research
- economic evaluation
- incidence modelling
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.