Grinsztejn B, Hosseinipour MC, Ribaudo HJ, Swindells S, Eron J, Chen YQ, et al. Effects of early versus delayed initiation of antiretroviral treatment on clinical outcomes of HIV-1 infection: results from the phase 3 HPTN 052 randomised controlled trial. Lancet Infect Dis. 2014;14:281–90.
Bavinton BR, Pinto AN, Phanuphak N, Grinsztejn B, Prestage GP, Zablotska-Manos IB, et al. Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study. Lancet HIV. 2018;5:e438–47.
Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Antiretroviral therapy for the prevention of HIV-1 transmission. N Engl J Med. 2016;375:830–9 Massachussetts Medical Society.
Eisinger RW, Dieffenbach CW, Fauci AS. HIV viral load and transmissibility of HIV infection undetectable equals untransmittable. J Am Med Assoc. 2019;321:451–2.
Granich RM, Gilks CF, Dye C, De Cock KM, Williams BG. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet. 2009;373:48–57.
Eaton JW, Menzies NA, Stover J, Cambiano V, Chindelevitch L, Cori A, et al. Health benefits, costs, and cost-effectiveness of earlier eligibility for adult antiretroviral therapy and expanded treatment coverage: a combined analysis of 12 mathematical models. Lancet Glob Health. 2013;2:23–34.
UNAIDS. 90-90-90: an ambitious treatment target to help end the AIDS epidemic. Geneva; 2014.
Levi J, Raymond A, Pozniak A, Vernazza P, Kohler P, Hill A. Can the UNAIDS 90-90-90 target be achieved? A systematic analysis of national HIV treatment cascades. BMJ global health. 2016;1(2):e000010.
Kim AA, Mukui I, N’gan’ga L, Katana A, Koros D, Wamicwe J, et al. Progress in reversing the HIV epidemic through intensified access to antiretroviral therapy: Results from a nationally representative population-based survey in Kenya. PLoS One. 2012;2016:11 Public Library of Science.
James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1789–858.
•• Celletti F, Cohn J, Connor C, Lee S, Giphart A, Montaner J. From policy to action: how to operationalize the treatment for all agenda. Journal of the International AIDS Society. 2016;19(1). This article puts forward an operational strategy for the development and adoption of a differentiated care model to support progress towards 90-90-90 goals under a Treat All policy.
Fox MP, Rosen S. Retention of adult patients on antiretroviral therapy in low- and middle-income countries: systematic review and meta-analysis 2008-2013. J Acquir Immune Defic Syndr. 2015;69:98–108.
Rosen S, Fox MP, Gill CJ. Patient retention in antiretroviral therapy programs in sub-Saharan Africa: a systematic review. PLoS Med. 2007;4:1691–701.
•• Bor J, Fox MP, Rosen S, Venkataramani A, Tanser F, Pillay D, et al. Treatment eligibility and retention in clinical HIV care: a regression discontinuity study in South Africa. PLoS Med. 2017;14:e1002463 This study examines the impact of early ART on retention in care in a rural South African setting. Importantly, it demonstrates that offering ART upon diagnosis improves retention in care, thus reducing the loss-to-follow up among patients who would have otherwise been enrolled in pre-ART care.
Haber N, Tanser F, Bor J, Naidu K, Mutevedzi T, Herbst K, et al. From HIV infection to therapeutic response: a population-based longitudinal HIV cascade-of-care study in KwaZulu-Natal, South Africa. Lancet HIV. 2017;4:e223–30.
Central Statistical Office Eswatini and Macro International. Swaziland Demographic and Health Survey 2006–07. 2008.
PHIA Project. Summary sheet: preliminary findings; Swaziland HIV incidence measurement survey 2: a population-based HIV impact assessment. 2017.
Kingdom of Eswatini. Monitoring the declaration of the commitment on HIV and AIDS (UNGASS): Swaziland Country report March 2010. 2010.
Jenniskens F. MaxART final report: phase 1. 2015.
Walsh FJ, Bärnighausen T, Delva W, Fleming Y, Khumalo G, Lejeune CL, et al. Impact of early initiation versus national standard of care of antiretroviral therapy in Swaziland’s public sector health system: study protocol for a stepped-wedge randomized trial. Trials. 2017;18.
World Health Organization. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. WHO, Geneva. 2015. Available at (Accessed on 15 May 2020): https://apps.who.int/iris/bitstream/10665/186275/1/9789241509565_eng.pdf.
•• Tymejczyk O, Brazier E, Yiannoutsos CT, Vinikoor M, van Lettow M, Nalugoda F, Urassa M, Sinayobye JD, Rebeiro PF, Wools-Kaloustian K, Davies MA. Changes in rapid HIV treatment initiation after national “treat all” policy adoption in 6 sub-Saharan African countries: regression discontinuity analysis. PLoS medicine. 2019 Jun 10;16(6):e1002822. This study reviews the impact of Treat All policies on ART uptake in six countries in sub-Saharan Africa (Burundi, Kenya, Malawi, Rwanda, Uganda, and Zambia). Examining “real world service delivery data,” this analysis found that national adoption of Treat All policies led to significant increases in early ART initiation.
World Health Organization. WHO HIV policy adoption and implementation status in countries: fact sheet. Geneva; 2018.
Haber N, Pillay D, Porter K, Bärnighausen T. Constructing the cascade of HIV care: methods for measurement. Curr Opin HIV AIDS. 2016;11:102–8.
UNAIDS. Global AIDS update 2018: miles to go. UNAIDS, Geneva. 2018. Available at (Accessed on 15 May 2020): https://www.unaids.org/sites/default/files/media_asset/miles-to-go_en.pdf.
World Health Organization. Fact sheet to the WHO consolidated guidelines on HIV testing services. WHO, Geneva. 2015. Available at (Accessed on 15 May 2020): https://apps.who.int/iris/bitstream/handle/10665/179931/WHO_HIV_2015.20_eng.pdf?sequence=1.
Ministry of Health. Swaziland Incidence Measurement Survey (SHIMS): First findings report. MOH, Mbabane. 2012.
Sharma M, Ying R, Tarr G, Barnabas R. Systematic review and meta-analysis of community and facility-based HIV testing to address linkage to care gaps in sub-Saharan Africa. Nature. 2015;528:S77–85 Nature Publishing Group.
Ulrich D, Kerr S, Ashkenas RN. The GE work-out: how to implement GE’s revolutionary method for busting bureaucracy and attacking organizational problems-fast! McGraw-Hill; 2002.
Okello V, Dlamini T, Nkambule T, Thwala-Tembe M, Delva W, Nyambe M, et al. The MaxART programme: strengthening community-based and facility-based interventions towards immediate access to ART in Swaziland. Oral Abstr 20th Int AIDS Conf July 20-25, 2014, Melbourne, Aust. 2014.
DiCarlo AL, Gachuhi AB, Mthethwa-Hleta S, Shongwe S, Hlophe T, Peters ZJ, Zerbe A, Myer L, Langwenya N, Okello V, Sahabo R. Healthcare worker experiences with Option B+ for prevention of mother-to-child HIV transmission in eSwatini: findings from a two-year follow-up study. BMC Health Serv Res. 2019;19(1):210.
Ministry of Health. Annual HIV Programs Report 2013: HTC, PMTCT, and ART. MOH, Mbabane. 2014.
Swaziland National Network of People Living With HIV/AIDS (SWANNEPHA). Positive health, dignity and prevention: findings and recommendations from a study led by and among people living with HIV in Swaziland in 2012. Mbabane; 2014.
Kingdom of Eswatini. Preliminary findings - Swaziland HIV incidence measurement survey 2: a population-based HIV impact assessment (SHIMS2 2016-207). 2017.
Ministry of Health Kingdom of Eswatini. HIV 2017 Annual program report. Mbabane; 2018.
Khan S, Walsh F, Spiegelman D, Mazibuko S, Pasipamire M, Lejeune C, et al. Time to antiretroviral therapy initiation under universal test and treat strategy in Swaziland: a stepped-wedge implementation trial. Abstr from 22nd Int AIDS Conf. 2018.
Pell C, Vernooij E, Masilela N, Simelane N, Shabalala F, Reis R. False starts in “test and start”: a qualitative study of reasons for delayed antiretroviral therapy in Swaziland. Int Health. 2018;10:78–83.
Kerschberger B, Jobanputra K, Schomaker M, Kabore SM, Teck R, Mabhena E, et al. Feasibility of antiretroviral therapy initiation under the treat-all policy under routine conditions: a prospective cohort study from Eswatini. J Int AIDS Soc. 2019;22:e25401 NLM (Medline).
Haberer JE, Sabin L, Amico KR, Orrell C, Galárraga O, Tsai AC, Vreeman RC, Wilson I, Sam‐Agudu NA, Blaschke TF, Vrijens B. Improving antiretroviral therapy adherence in resource‐limited settings at scale: a discussion of interventions and recommendations. J INT AIDS SOC. 2017;20(1):21371.
Khan S, Spiegelman D, Walsh FJ, Mazibuko S, Pasipamire M, Chai B, et al. Universal test and treat (UTT) versus standard of care for access to antiretroviral therapy in HIV clients: The MaxART stepped-wedge randomized controlled health systems trial in Swaziland. Oral Abstr 22nd Int AIDS Conf 23-27 July 2018, Amsterdam, Netherlands. Switzerland; 2018;
Shabalala FS, Vernooij E, Pell C, Simelane N, Masilela N, Spiegelman D, et al. Understanding reasons for discontinued antiretroviral treatment among clients in test and treat: a qualitative study in Swaziland. J Int AIDS Soc. 2018;21:e25120 Wiley.
Chao A, Spiegelman D, Khan S, Walsh F, Mazibuko S, Pasipamire M, et al. Mortality Under Early Access to Antiretroviral Therapy Versus Eswatini’s National Standard of Care: The MaxART Clustered Randomized Stepped Wedge Trial. HIV Medicine. In Press. 2020.
Bärnighausen T, Salomon JA, Sangrujee N. HIV treatment as prevention: issues in economic evaluation. PLoS Med. 2012;9:e1001263.
Ogbuoji O, Geldsetzer P, Wong C, Khan S, Mafara E, Lejeune C, Walsh F, Okello V, Bärnighausen T. Impact of immediate initiation of antiretroviral therapy on HIV patient satisfaction. Aids. 2020 Feb 1;34(2):267-76.
Miller WC, Powers KA, Smith MK, Cohen MS. Community viral load as a measure for assessment of HIV treatment as prevention. Lancet Infect Dis. 2013;13:459–64.
World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for rreating and preventing HIV infection: recommendations for a public health approach. Geneva; 2013.
Joint United Nations Programme on HIV/AIDS. How AIDS changed everything. MDG6: 15 years, 15 lessons of hope from the AIDS response. Geneva; 2015.
Lecher S, Williams J, Fonjungo PN, Kim AA, Ellenberger D, Zhang G, et al. Progress with scale-up of HIV viral load monitoring—seven sub-Saharan African countries, January 2015–June 2016. MMWR Morb Mortal Wkly Rep. 2016;65:1332–5 Department of Health and Human Services.
Jobanputra K, Parker LA, Azih C, Okello V, Maphalala G, Jouquet G, et al. Impact and programmatic implications of routine viral load monitoring in Swaziland. J Acquir Immune Defic Syndr. 2014;67:45–51.
Ministry of Health Kingdom of Eswatini. HIV 2018 Program Annual Report. Mbabane; 2019.
Dorward J, Drain PK, Garrett N. Point-of-care viral load testing and differentiated HIV care. Lancet HIV. 2018;5:e8–9 Elsevier Ltd.