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. 2025 Jan 29;20(1):e0316794.
doi: 10.1371/journal.pone.0316794. eCollection 2025.

A simple tool to evaluate the effectiveness of HIV care for settings with gaps in data availability (ESTIHIV)

Dorthe Raben  1 , Marie L Jakobsen  1 , Jamina Trajanovska  2 , Justyna Kowalska  3 , Anna Vassilenko  4 , Snezana Dragas  5 , Arjan Harxhi  6 , Gordana Dragovic  7 , Nadine J Jaschinski  1 , Bastian Neesgaard  1 , Klaus Hjorth-Larsen  1 , Harmony Garges  8 , Joel Gallant  9 , Jens D Lundgren  1 , Andrew Philips  10 , Valentina Cambiano  10 , Yazdan Yazdanpanah  11   12 , Amanda Mocroft  1   10
Affiliations

A simple tool to evaluate the effectiveness of HIV care for settings with gaps in data availability (ESTIHIV)

Dorthe Raben et al. PLoS One. .

Abstract

Many HIV clinics with poor IT-infrastructure are unable to report data on individuals in care with HIV, on antiretroviral treatment (ART) and virologically suppressed (VS), with the aim of monitoring the HIV Continuum of Care to estimate efficacy of HIV treatment programmes. We developed an estimation-tool, ESTIHIV, and determined the minimal data required for a random sample, to produce representative estimates, with a specified level of precision, of people with HIV on ART and VS. For proof of concept, 8852 HIV positive persons from seven clinics in seven different countries, with a follow-up visit during 2017, were included. Of those, 93.8% were on ART (95% CI 93.3-94.2) and 76.7% were VS (95% CI 75.8-77.6). In 2022, we tested the tool in the RESPOND Cohort for all countries with more than 100 participants under follow-up in 2019. We included 26,426 HIV positive persons from clinics in 27 countries, 97.8% (95% CI 97.6-98.0) were on ART and 91.5% were VS (95% CI 91.2-91.8%). There was good agreement between the RESPOND country estimates of ART and VS and the estimations using a random sample calculated in ESTIHIV. With ESTIHIV, clinics can produce a reliable estimate in figures for reporting and for monitoring the effectiveness of care in their clinics.

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Conflict of interest statement

AM has received personal honoraria, travel support, and lecture fees from Gilead and ViiV, and consultancy fees from Eiland and Bonnin, all outside the submitted work. JG is an employee at Gilead Sciences. HG is an employee at ViiV Healthcare. For the remaining authors none were declared.

Figures

Fig 1
Fig 1
a) Continuum of care for the participating 7 clinics (anonymised) for the proof of concept in 2017 on: a. missing viral load; b) % on ART and VS at last clinic visit.
Fig 2
Fig 2
Application and testing of the tool to RESPOND Cohorts: a) comparison of all data vs random samples on ART and b) comparison of all versus random sample on virologic suppression** in RESPOND country cohorts, year 2019. *p < 0.05. **Missing assumed failure.
See this image and copyright information in PMC

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