Independent association of factors with (i) wanting to start ART for modest health benefit^* in ART naïve people with CD4≥350/cells/µL.

<p>*tend to agree or strongly agree combined, versus undecided/tend to disagree/strongly disagree combined.</p>#<p>using logistic regression analysis; p values by likelihood ratio test.</p>$<p>score of 10 or more, based on total distress score for 19 physical symptoms, each scored 0 (symptom not present or no distress) to 4 (distressed very much by symptom).</p

Association of factors with (i) wanting to start ART for modest health benefit^* and (ii) wanting to start ART to reduce infectiousness^* among 281 ART naïve people with CD4≥350/cells/µL.

<p>* tend to agree or strongly agree combined, versus undecided/tend to disagree/strongly disagree combined.</p><p>P values by chi-squared tests, and chi-squared tests for trend.</p>#<p>usual alcohol intake of at least 5 units 4 or more times a week, or at least 10 units 2–3 times a week.</p>$<p>score of 10 or more, based on total distress score for 19 physical symptoms, each scored 0 (symptom not present or no distress) to 4 (distressed very much by symptom).</p

Independent association of factors with (ii) wanting to start ART to reduce infectiousness^* among 281 ART people who were ART naïve with CD4≥350cells/µL.

<p>* tend to agree or strongly agree combined, versus undecided/tend to disagree/strongly disagree combined;</p>#<p>using logistic regression analysis; p values by likelihood ratio test.</p

Attitudes to early ART among 281 ART naïve individuals with CD4 ≥350 cells/µL.

<p>Attitudes to early ART among 281 ART naïve individuals with CD4 ≥350 cells/µL.</p

Flowchart of ASTRA clinic recruitment and questionnaire collection procedures.

<p>Flowchart of ASTRA clinic recruitment and questionnaire collection procedures.</p

Cumulative incidence of mortality up to four years after start of ART by region and CD4 count at ART initiation, corrected in South Africa for mortality under-ascertainment.

<p>Cumulative incidence of mortality up to four years after start of ART by region and CD4 count at ART initiation, corrected in South Africa for mortality under-ascertainment.</p

<b>Mortality rate ratios comparing Europe and North America to South Africa by duration on antiretroviral therapy, adjustment for baseline patient characteristics, and restricted to specific patients and cohorts in sensitivity analyses.</b>

a<p>Adjustments were for baseline gender, CD4 count, clinical stage, viral load, and calendar period and are detailed in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001718#pmed-1001718-t003" target="_blank">Table 3</a>.</p>b<p>Mortality rates were predicted from a multivariable model for each region and ART duration for a common group of patients (women aged 30–45 starting ART with a CD4 count 100–199 cells/µl, advanced clinical stage, viral load 4–5 log10 copies/ml, and starting ART in 2004–2007), and then corrected by the inverse of the weighted self-assessed completeness of mortality ascertainment for each region.</p>c<p>Based on cohort-assessed completeness of mortality ascertainment and including seven European and six North American cohorts.</p>d<p>All North American cohorts reported linking to death registries at least annually, whereas only three European cohorts provided linkage—one annually in patients <65 years old, one every two years, and one every three years.</p><p><b>Mortality rate ratios comparing Europe and North America to South Africa by duration on antiretroviral therapy, adjustment for baseline patient characteristics, and restricted to specific patients and cohorts in sensitivity analyses.</b></p

Relative mortality by region and duration on ART comparing European and North American cohorts to South Africa. (A) Crude rates, (B) adjusted for baseline covariates*, (C) corrected for cohort-assessed mortality under-ascertainment** and adjusted for baseline covariates, and (D) limited in Europe and North America to patients with sexual acquisition of HIV, adjusted for baseline covariates.

<p>*Adjusted for baseline gender, CD4 count, clinical stage, viral load, and calendar period. **In order to correct for cohort-assessed completeness of mortality ascertainment, mortality was predicted for each region and duration from a multivariable model for each cohort for women aged 30–45 starting ART with a CD4 count 100–199 cells/µl in 2004–2007, with advanced clinical stage and viral load 4–5 log copies/ml. Each mortality rate in Europe and North America was multiplied by the inverse of the cohort-assessed proportion of deaths ascertained (weighted estimate from participating cohorts), prior to converting to rate ratios relative to South Africa.</p

Predicted mortality by cohort and region.

<p>Predicted for women aged 30–45, starting ART with a CD4 count 100–199 cells/µl in 2004–2007, advanced clinical stage, and viral load 4–5 log copies/ml. The squares are scaled to the square root of cohort size, the horizontal lines represent 95% CIs, and the dotted vertical lines represent regional estimates for each duration. A mortality rate could not be estimated for one European cohort between 6 and 12 months on ART due to the absence of events. RSA, South Africa; NA, North America; EUR, Europe.</p