Early Access to ART for All in Swaziland: Effects on Economic Outcomes
- Conditions
- HIV/AIDS
- Interventions
- Other: Early Access to ART for All
- Registration Number
- NCT03789448
- Lead Sponsor
- Till Bärnighausen
- Brief Summary
The purpose of this study is to evaluate the impact of offering early antiretroviral therapy to HIV-positive individuals in government-managed health facilities in Swaziland on a range of economic outcomes
- Detailed Description
The MaxART study is a three-year stepped-wedge randomized trial with open enrollment for all adults 18 years and older across 14 rural health facilities in Swaziland's Hhohho Region. The main trial registration is accessible at: https://clinicaltrials.gov/ct2/show/record/NCT02909218.
This registration is specific to the economic evaluation of the MaxART study which aims to quantify the causal impacts of early ART initiation (compared to national standard care) on a range of key economic outcomes, including healthcare expenditures, productivity, and household wealth.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 3019
- All HIV-positive individuals who are aged 18 years or older, are ART naïve and attend the health facilities included in the study
- All HIV-positive individuals who are <18 years of age
- All HIV-positive pregnant or breastfeeding women
- All HIV-positive individuals who did not consent to participate
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SEQUENTIAL
- Arm && Interventions
Group Intervention Description Early Access to ART for All Early Access to ART for All HIV-positive individuals who are aged 18 years or older are initiated on ART regardless of client's immunological and clinical staging (excluding pregnant or breastfeeding women)
- Primary Outcome Measures
Name Time Method Total healthcare expenditures (for hospitalization and primary care) 12 months Including direct health care costs (e.g., surgery, medication, consultation) and indirect costs (e.g., transport to clinic, payment for someone to look after children, salary lost for time off...)
Total productivity hours 24 hours Total Hours per day spent on income generation activities
- Secondary Outcome Measures
Name Time Method Household Assets Ownership and Living Standards Index At study completion, an average of 1.5 years Aggregated index based on ownership of assets (e.g., refrigerator, TV, table, phone...) and living standards (e.g., flush toilet, cooking facilites, floor/wall/roof material...), total scale score is determined via principal component analysis and averaged around 0
Rate of participants with current employment At study completion, an average of 1.5 years Employment rate among participants, including full-time and part-time salary work
Total sum of self-reported monthly expenditures of the participant's household 12 months Including food and non-food items (e.g., electricity, water, transport, personal care items, insurance, festivals, etc.)