Baisley K. auteur aut IRD Orne-Gliemann J. auteur aut IRD Larmarange Joseph auteur aut IRD Plazy M. auteur aut IRD Collier D. auteur aut IRD Dreyer J. auteur aut IRD Mngomezulu T. auteur aut IRD Herbst K. auteur aut IRD Hanekom W. auteur aut IRD Dabis F. auteur aut IRD Siedner M.J. auteur aut IRD Iwuji C. auteur aut IRD text journalArticle eng text/pdf reformatted digital access Objectives : Population- based universal test and treat (UTT) trials have shown an impact on population- level virological suppression. We followed the ANRS 12249 TasP trial population for 6 years to determine whether the intervention had longer- term survival benefits. Methods: The TasP trial was a cluster-randomized trial in South Africa from 2012 to 2016. All households were offered 6- monthly home- based HIV testing. Immediate antiretroviral therapy (ART) was offered through trial clinics to all people living with HIV (PLHIV) in intervention clusters and according to na-tional guidelines in control clusters. After the trial, individuals attending the trial clinics were transferred to the public ART programme. Deaths were ascertained through annual demographic surveillance. Random- effects Poisson regression was used to estimate the effect of trial arm on mortality among (i) all PLHIV; (ii) PLHIV aware of their status and not on ART at trial entry; and (iii) PHLIV who started ART during the trial. Results: Mortality rates among PLHIV were 9.3/1000 and 10.4/1000 person- years in the control and intervention arms, respectively. There was no evidence hat the intervention decreased mortality among all PLHIV [adjusted rate ratio (aRR) = 1.10, 95% confidence interval (CI) = 0.85- 1.43, p = 0.46] or among PLHIV who were aware of their status but not on ART. Among individuals who initiated ART, the intervention decreased mortality during the trial (aRR = 0.49, 95% CI = 0.28- 0.85, p = 0.01), but not after the trial ended. Conclusions: The 'treat all' strategy reduced mortality among individuals who started ART but not among all PLHIV. To achieve maximum benefit of immedi-ate ART, barriers to ART uptake and retention in care need to be addressed. specialized AFRIQUE DU SUD 052MALTRA03 050MEDECI 108DEMOG1 106PROSO 23 8 922-928 2022 1464-2662 https://www.documentation.ird.fr/hor/fdi:010087012 10.1111/hiv.13263 1464-2662 [F B010087012] https://www.documentation.ird.fr/hor/fdi:010087012 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087012.pdf IRD - Base Horizon / Pleins textes 2022-12-14 2025-02-24 fdi:010087012 fre