MaxART: Ending New Infection in Swaziland Phase II


Short term: To ensure at least 90% of those in need of treatment based on current guidelines are on treatment by the end of 2014

Long term vision: To ensure long-term access to treatment and care for HIV positive patients in need of treatment and to provide proof of concept of the benefits of Treatment as Prevention, thereby catalyzing the widespread adoption of a new form of HIV prevention in Southern Africa and beyond.


The three-year Early Access to ART for All implementation study (2014-2017) is introduced to better understand how to scale up immediate access to HIV treatment in Swaziland. While compelling research findings show that the use of early ART substantially reduces new HIV infections, practical questions remain concerning specific elements of implementation of early treatment for people who are feeling healthy. These questions include whether or not people will seek health services,  accept and start treatment, and stay in care. The study is designed to answer these questions.

The study will evaluate the feasibility, acceptability, clinical outcomes, affordability, and scalability of offering ART to all HIV-positive individuals in Swaziland’s government-managed health system regardless of CD4 count or stage of disease. The project expects to enrol and follow up 4,353 clients not yet on ART, among whom 2,376 with newly diagnosed HIV infection.

A strategic mix of multidisciplinary research methodologies will be applied and community participation is an integral part of this implementation research:

  • clinical mentoring
  • community mobilisation
  • clinical data research
  • social science research
  • economic evaluation
  • incidence modelling

The evidence generated will inform Swaziland’s HIV guidelines and provide valuable insights for the Southern African region about shifting treatment guidelines and the implementation of ‘Treatment as Prevention’. The study also contains a regional and international linking and learning component.


Name: MaxART
Status: Start: July, 2014
End: December, 2016
Principal Investigator: Gabriela Gomez
Departments(s): AIGHD
Partners: National Emergency Response Programme (NERCHA)

Clinton Health Access Initiative (CHAI)

Southern Africa HIV and AIDS Information Disseminations Services (SafAIDS)

Global Network of People Living with HIV (GNP+)

University of Amsterdam Centre for Social Science and Global Health 

South African Centre for Epidemiological Modelling and Analysis (SACEMA)

Dutch Postcode Lottery

Contact information: Stephan Rupert, project manager (
Duration: Initiated
Funded by: This research is funded by the Stop Aids Now through the University of Amsterdam
Countries: Swaziland