Results of meta-analysis of CD4 staging for POC CD4 and laboratory testing (95% confidence intervals shown in brackets).

<p>Results of meta-analysis of CD4 staging for POC CD4 and laboratory testing (95% confidence intervals shown in brackets).</p

Prevalence and incidence curves.

<p>Prevalence and incidence for all three care contexts, for an arbitrarily chosen calibrated epidemiological parameter set. For all parameter sets see Fig C in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0158303#pone.0158303.s001" target="_blank">S1 Supporting Information</a>. The colours correspond to (from top to bottom on both panels): grey—current care (CC) context, orange—enhanced counselling and testing (ECT), blue—universal test and treat (UTT). Also shown on the left panel are the confidence intervals of the UNAIDS prevalence estimates (inner circles) and twice the confidence intervals (outer crosses).</p

Study Characteristics and Outcomes Reported.

<p>FSW – female sex worker, ART – antiretroviral therapy, HIV – human immunodeficiency virus, VS – viral suppression, MSM – men who have sex with men, GP – general population, IDU – injecting drug user, PC – prospective cohort, CS – cross-sectional, RCT – randomised controlled trial, RCC – retrospective case-control, PDI – peer driven intervention, YPLH – young people living with HIV, HERMITAGE – HIV's Evolution in Russia – Mitigating Infection Transmission and Alcoholism in a Growing Epidemic, WISH – Women's Information and Safe House, HOPE – Hospital visit is an Opportunity for Prevention and Engagement, ACCESS – AIDS Care Cohort to evaluate Exposure to Survival Services.</p>a<p>Additional data or clarifications were provided by corresponding author/s.</p>b<p>Corresponding author confirmed that participants were FSWs from the Mombasa FSW cohort.</p>c<p>Outcome data is based on entire cohort rather than subset of participants in referenced study; in some cases this data was provided by study authors.</p><p>Study Characteristics and Outcomes Reported.</p

Cost-effectiveness acceptability curves.

<p>These curves show the probability that introduction of POC CD4 testing compared to laboratory CD4 testing is cost-effective at a range of decision rule thresholds for the 1 year projection (left) and 3 year projection (right). The colours correspond to (left to right within each plot): grey—current care (CC) context, orange—enhanced counselling and testing (ECT), blue—universal test and treat (UTT). The dashed line shows South African GDP per capita.</p

Impact of different prevention policies on the overall HIV incidence in three epidemic types.

<p>A generic intervention that reduces HIV transmission by 80% per sex-act is used. Policy 1 (red) prioritizes the low-activity group based on the largest burden of new HIV infections estimated from the generic Modes of Transmission model (gMOT) in 2012. gMOT-guided Policy 1 redistributes finite resources from condom-use coverage in high-risk groups to a generic intervention focus on low-activity individuals. gMOT-guided Policy 2 (blue) prioritizes the low-activity group but resources are added to existing interventions (baseline condom use in high-risk partnerships is sustained). Policy 3 (green) is guided by an increasing long-term population attributable fraction over time t (PAF_t), and therefore prioritizes epidemic drivers to receive the generic intervention. Policy 4 is not informed by an epidemic appraisal, and randomly allocates additional resources across subgroups. Each policy is implemented in 2012, is immediately scaled-up, and sustained over 30 years of follow-up. The person-years of the generic intervention are fixed throughout the follow-up period, and equivalent within each simulated synthetic epidemic type.</p

Forest plot of (A) median CD4 count and (B) median gains in CD4 count among HIV-infected FSWs on ART and starting ART.

<p>Study estimates are grouped by country income and ordered by time on ART. ^a N refers to a subset of FSWs who were eligible for ART upon HIV diagnosis and enrolled in HIV care following HIV diagnosis. ART  =  antiretroviral, FSW  =  female sex workers, CI  =  confidence interval, NR  =  not reported, N =  sample size of FSWs available for each outcome, N_p =  number of independent study populations, m =  median, IQR  =  interquartile range.</p

Forest plot of current ART use among HIV-infected FSWs.

<p>Study estimates are grouped by country income and ordered by study-period. The star symbol (*) highlights the study estimates (one per study population) included in the pooled overall or subgroup estimates. Only study estimates with a known time period of data collection which were measured among at least 10 FSWs were used for pooling. I² and p-values are the measures of heterogeneity used. ^a ART was provided to FSWs in the Kenyan cohort from 2004, ^b Sample is ‘active’ FSWs, ^c Sample is ‘active’ and ‘former’ FSWs. ART  =  antiretroviral therapy, FSW  =  female sex workers, CI  =  confidence interval, NR  =  not reported, n =  number of FSWs with each outcome, N =  sample size of FSWs available for each outcome, N_p =  number of independent study populations.</p

Forest plot of the fraction of HIV-infected FSWs on ART and starting ART with (A) CD4 counts <200 cells/mm³ (B) CD4 counts 200–499 cells/mm³ and (C) CD4 counts >500 cells/mm³.

<p>Study estimates are grouped by country income and ordered by time on ART. The star symbol (*) highlights the study estimates (one per study population) included in the pooled overall estimates. For studies providing estimates over multiple time-periods, only one estimate was used for pooling (the most recent estimate from that study). I² and p-values are the measures of heterogeneity used. ^a ART initiation criteria is CD4 count <200 cells/mm³. ART  =  antiretroviral, FSW  =  female sex workers, CI  =  confidence interval, NR  =  not reported, n =  number of FSWs with each outcome, N =  sample size of FSWs available for each outcome, N_p =  number of independent study populations.</p

Forest plot of ART adherence among HIV-infected FSWs.

<p>Study estimates are grouped by country income and ordered by time on ART. The star symbol (*) highlights the study estimates (one per study population) included in the pooled overall or subgroup estimates. Only study estimates with a known sample size of at least 10 FSWs were used for pooling. For studies providing estimates over multiple time-periods, only one estimate was used for pooling (the most recent estimate from that study). I² and p-values are the measures of heterogeneity used. ART  =  antiretroviral, FSW  =  female sex workers, CI  =  confidence interval, NR  =  not reported, n =  number of FSWs with each outcome, N =  sample size of FSWs available for each outcome, N_p =  number of independent study populations, m =  median, PDI  =  peer driven intervention, PC  =  pill count, SR  =  self-report, VAS  =  visual analog scale.</p

Forest plot of ever ART use among HIV-infected FSWs.

<p>Study estimates are grouped by country income and ordered by time-period. The star symbol (*) highlights the study estimates (one per study population) included in the pooled overall or subgroup estimates. I² and p-values are the measures of heterogeneity used. ^a Sample is ‘active’ FSWs, ^b Sample is ‘active’ and ‘former’ FSWs. ART  =  antiretroviral therapy, FSW  =  female sex workers, CI  =  confidence interval, n =  number of FSWs with each outcome, N =  sample size of FSWs available for each outcome, N_p =  number of independent study populations.</p