ATRACT: Analysis of national lab database to evaluate the HIV treatment rollout in South Africa

ATRACT was a 5-year NIH R01 funded projects which is using South Africa’s entire national public-sector laboratory monitoring database to create a national patient-level cohort. We are also using this cohort to evaluate the national program. ATRACT is a prospective cohort study of over 20 million laboratory observations and over 3 million patients designed to answer four questions: 1) What is the effect of the national HIV testing campaign on linkage to HIV care and treatment?; 2) What are national retention rates before and after ART initiation?; 3) What are the long run treatment outcomes for the national patient cohort?; and 4) What are the effects of immediate vs. deferred ART eligibility at a CD4 count of 350 on retention and clinical outcomes? To answer these questions, we used novel methods for causal inference and helped to increase South African capacity for implementing these methods.