Fig 1.
Distribution of earliest CD4 counts among patients seeking care for HIV in 2013.
Data include all patients presenting to the Hlabisa HIV Treatment and Care Programme, the public sector ART program serving Hlabisa sub-district, rural KwaZulu-Natal. Data are shown for 2013, the last complete year for which data were available, and are top-coded at 999 cells. Under the assumption that the 2013 distribution of first CD4 counts reflects the future distribution among patients seeking care, the area under the curve between 350 and 500 shows the proportion of patients who would be expected to be newly eligible based on the January 2015 guideline revision. The proportion to the right of 500 shows the additional proportion of patients who would be expected to be eligible if South Africa adopts September 2015 WHO recommendations to initiate all patients regardless of CD4 count.
Fig 2.
Proportion of patients starting ART within 6 months, by earliest CD4 count.
Graph plots the probability of starting ART conditional on CD4 count, as observed in patients with a first CD4 count 12 August 2011–30 June 2012. Each dot is the binned average within a range of CD4 cells: 0–24, 25–49,…,975–999. Fitted regression lines are from a logistic regression model, allowing for separate slopes on either side of the threshold and an intercept shift at the threshold. The orange line displays the predicted (extrapolated) probabilities of initiation that would be expected if all patients were eligible for ART regardless of CD4 count. 95% confidence intervals are shown for the regression fit. The area under the red lines reflects the proportion of patients initiating under 2011–2014 guidelines. The area to the right of the 350 threshold, between the orange line and red line reflects the proportion of patients who would be expected to initiate under eligibility expansions to 500 and to all CD4 counts. The dotted horizontal line illustrates the upper bound used in sensitivity analysis, assuming that if eligible ART uptake above 350 was equal to ART uptake observed at 350.
Fig 3.
Projected impact of eligibility expansions on the proportion starting ART.
Each dot is the binned average within a range of CD4 cells: 0–24, 25–49,…,975–999. Fitted regression lines are from a logistic regression model, allowing for separate slopes on either side of the threshold and an intercept shift at the threshold. The dotted line displays the predicted (extrapolated) probabilities of initiation that would be expected if all patients were eligible for ART regardless of CD4 count. The area under the solid lines reflects the proportion of patients initiating under 2011–2014 guidelines. The area to the right of the 350 threshold, between the dashed line and solid line reflects the proportion of patients who would be expected to initiate under eligibility expansions to 500 and to all CD4 counts.
Table 1.
Characteristics of the sample.
Table 2.
Projected impact of eligibility expansions on numbers of new ART initiators.