LogicalThinking

[jackolney]

The whole premise of this work was to demonstrate how intervening at a single point in care is silly; as due to upstream / downstream weaknesses in care you will never truly realise the full impact of your intervention.

To test this, we need to bolster care. So, we should sequentially make care perfect and then show the impact of our interventions

In other words, for a specific intervention, I want to make care upstream perfect, see the impact of the intervention, then make care downstream perfect and see the impact of the intervention

Look at the impact of our interventions on:

1. Excess mortality
2. DALYs

Let the narrative of the paper guide the analysis

[jackolney]

Making a connection between how much each intervention patches the 'leak' in the cascade that it aims to address and how much it reduces the overall HIV health losses

[jackolney]

PLAN

Build up 'perfect' care and then sequentially weaken care from that point to illustrate the importance of each aspect of care

In the absence of interventions (no HBCT either)

• [x] HIV-testing (VCT & PICT at normal levels)
• [x] Linkage at normal levels
• [x] CD4 testing loss at normal levels
• [x] CD4 test results loss at normal levels
• [x] ART initiation delay normal
• [x] ART Dropout at normal levels
• [x] ART Adherence at normal levels

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To begin with, to make 'perfect care':

• [x] EVERYTHING 100%
• [x] As soon as you become infected, get an HIV-test the NEXT DAY (or maybe the same day)
• [x] Perfect linkage to care.
• [x] Immediate CD4 test
• [x] Immediate CD4 test result (or the day after)
• [x] Perfect retention in pre-ART care
• [x] Next CD4 test the following day (could be intensive)... or a short time away
• [x] ART the very day that you become eligible.
• [x] Total adherence.
• [x] ZERO dropout from ART.

I don't think I need to be altering tx guidelines Additionally, ignore 2010, just start from 2004...

[jackolney]

Everything kinda grinds to a halt if you set the VCT test time to 1 day...

Try only giving people one entrance to care... They don't need to keep reappearing if they get in everytime