HIV program outcomes for Jamaica before and after “Treat All” : A population-based study using the national treatment services database

Objective The study aims to assess changes in HIV treatment outcomes for Jamaica after the implementation of the WHO Treat All strategy in January 2017, as well as identify variables associated with clinical stage at diagnosis and viral load status, in order to understand implications for enhancing the HIV clinical cascade and boosting progress towards the UNAIDS 90-90-90 targets. Method This is a population-based study using the National Treatment Service Information System. The sample consists of persons 15 years and older, placed on treatment before and after Treat All was implemented, across all 4 regional health authorities in Jamaica. Patients were assessed for two binary outcomes: 1. stage at HIV diagnosis (early/baseline CD4 cell count ≧350 cells/mm3, or late/ baseline CD4 <350 cells/mm3), 2. viral load status achieved after ART initiation (suppressed/