Expectations about future health and longevity in Kenyan and Ugandan communities receiving a universal test-and-treat intervention in the SEARCH trial

Figures & data

Table 1. Descriptive characteristics of study participants in SEARCH intervention communities.

	Baseline	Follow-upyear 1
	No. (%)	No. (%)	p-Value
No. individuals	2676	3410
No. households	2670	2695
HIV status
HIV+, detectable viral load	526 (19.7)	164 (4.8)	<0.001
HIV+, undetectable viral load	535 (20.0)	1,084 (31.8)	<0.001
HIV- status	1615 (60.4)	2162 (63.4)	0.009
Female	1706 (63.8)	2209 (64.8)	0.723
Age categories
18–25 years old	530 (19.8)	561 (16.5)	0.151
26–35 years old	730 (27.3)	859 (25.2)	0.043
36–45 years old	602 (22.5)	808 (23.7)	0.765
46–80 years old	814 (30.4)	1182 (34.7)	0.004
Education level
No education	439 (16.4)	503 (14.8)	0.068
Primary education	1669 (62.4)	2201 (64.6)	0.121
Secondary or more education	567 (21.2)	703 (20.6)	0.839
Married/cohabiting	1828 (68.3)	2430 (71.3)	0.117
Wealth index
Least wealth	576 (21.6)	655 (19.2)	0.012
Less wealth	549 (20.6)	667 (19.6)	0.260
Middle wealth	512 (19.2)	658 (19.3)	0.876
More wealth	520 (19.5)	693 (20.3)	0.317
Most wealth	512 (19.2)	737 (21.6)	0.006
Region
Southwest Uganda	837 (31.3)	1064 (31.2)	0.744
Eastern Uganda	818 (30.6)	1100 (32.3)	0.744
Kenya	1021 (38.2)	1246 (36.5)	0.532

Notes: p-Values based on chi-squared tests comparing characteristics of participants at baseline and follow-up. Wealth quintiles are based on a wealth index created using principal components analysis of ownership of 47 items. Characteristics reported are for participants aged 18–80 years, with HIV status and HIV-1 viral load information.

Figure 1. Trends in survival at baseline and follow-up year 1. Notes: Each bar represents participants’ subjective expectations to survive to age 50, 60, 70, and 80 using a 5-point Likert scale. Responses are presented separately for baseline and follow-up year 1. Expectations about survival to each of the target ages of 50, 60, 70, and 80 years were elicited from participants aged below the corresponding target age.

Table 2. Survival, health, and economic expectations of participants, by HIV status and over time in SEARCH intervention communities.

	Baseline				Follow-up year 1
	HIV+, detectable viral load	HIV+, undetectable viral load	HIV-uninfected	Full Sample	HIV+, detectable viral load	HIV+, undetectable viral load	HIV-uninfected	Full sample
	No. (%)	No. (%)	No. (%)	No. (%)	No. (%)	No. (%)	No. (%)	No. (%)
Very likely or almost certain to survive to:
50 years	204 (44.3)	237 (56.6)	619 (55.3)	1060 (53.0)	73 (50.7)	468 (56.0)	955 (65.7)	1496 (61.5)
60 years	153 (30.2)	203 (40.8)	607 (45.0)	963 (40.9)	60 (38.2)	478 (47.6)	981 (55.3)	1519 (51.7)
70 years	93 (19.5)	133 (26.3)	453 (31.6)	679 (28.1)	38 (26.0)	315 (31.8)	751 (39.8)	1104 (36.5)
80 years	72 (15.3)	93 (18.7)	347 (23.0)	512 (20.7)	31 (22.0)	214 (22.5)	569 (29.2)	814 (26.8)
Expects much better or somewhat better:
Health in 1 year	288 (56.8)	279 (54.6)	902 (57.7)	1469 (56.9)	104 (65.0)	703 (67.0)	1363 (64.9)	2170 (65.6)
Health in 3 years	313 (59.5)	312 (58.3)	1,004 (62.2)	1629 (60.9)	110 (67.1)	744 (68.6)	1478 (68.4)	2332 (68.4)
Standard of living in community in 1 year	239 (45.4)	228 (42.6)	739 (45.8)	1206 (45.1)	74 (45.1)	534 (49.3)	1194 (55.2)	1802 (52.8)
Household financial well-being in 3 years	258 (49.0)	225 (42.1)	808 (50.0)	1291 (48.2)	80 (48.8)	577 (53.2)	1216 (56.2)	1873 (54.9)

Notes: Analyses were limited to participants aged 18–80 years, with HIV status and HIV-1 viral load information. Expectations about survival to each of the target ages of 50, 60, 70, and 80 years were elicited from participants who were younger than the corresponding target age.

Table 3. Bivariate logistic regression results at baseline

	Very likely or almost certain to survive to
	50 years	60 years	70 years	80 years
	OR [95% CI]	OR [95% CI]	OR [95% CI]	OR [95% CI]
HIV status and viral load
Ref: HIV+, detectable viral load	Ref.	Ref.	Ref.	Ref.
HIV+, undetectable viral load	1.64*** [1.26–2.14]	1.59*** [1.22–2.06]	1.48* [1.10–2.00]	1.28 [0.91–1.79]
HIV- status	1.56*** [1.25–1.94]	1.89*** [1.52–2.35]	1.92*** [1.49–2.47]	1.66*** [1.26–2.19]
Observations	2000	2352	2415	2477
Expected future health
Better or much better health in 1 year	1.90*** [1.58–2.29]	1.80*** [1.51–2.13]	1.63*** [1.35–1.96]	1.63*** [1.32–2.00]
Observations	1931	2270	2339	2403
Much better health in 1 year	2.92*** [2.19–3.88]	2.34*** [1.84–2.98]	1.84*** [1.44–2.35]	1.79*** [1.38–2.33]
Observations	1931	2270	2339	2403
Better or much better health in 3 years	1.91*** [1.58–2.29]	1.81*** [1.52–2.15]	1.50*** [1.24–1.82]	1.54*** [1.25–1.89]
Observations	2000	2352	2415	2477
Much better health in 3 years	2.77*** [2.20–3.48]	2.06*** [1.69–2.51]	1.56*** [1.27–1.92]	1.50*** [1.20–1.88]
Observations	2000	2352	2415	2477

Notes: OR, odds ratio; 95% CI, 95% confidence interval. Logistic regression model was used to separately examine the association between the binary dependent variables and each of the five independent variables: (1) HIV status and HIV-1 viral load; (2) better or much better health in 1 year; (3) much better health in 1 year; (4) better or much better health in 3 years; (5) much better health in 3 years in separate logistic regression models. For each of the target ages of 50, 60, 70, and 80 years, the sample was limited to participants who were younger than the target age. 95% confidence intervals calculated using robust standard errors clustered at the individual level are reported in brackets.

*p < .05.

***p < .001.

Table 4. Adjusted logistic regression results using pooled data from baseline and follow-up.

	Very likely or almost certain to survive to				Very likely or almost certain to have better
	50 years	60 years	70 years	80 years	Health in 1 year	Health in 3 years	Standard of living in this community in 1 year	Household financial well-being in 3 years
	AOR	AOR	AOR	AOR	AOR	AOR	AOR	AOR
	[95% CI]	[95% CI]	[95% CI]	[95% CI]	[95% CI]	[95% CI]	[95% CI]	[95% CI]
Follow-up year 1 indicator variable	1.29** [1.10–1.53]	1.53*** [1.31–1.77]	1.72*** [1.48–2.01]	1.72*** [1.45–2.03]	2.12*** [1.82–2.47]	1.63*** [1.40–1.89]	1.49*** [1.29–1.71]	1.41*** [1.23–1.61]
HIV status and viral load HIV+, detectable viral load	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
HIV+, undetectable viral load	1.24 [0.98–1.57]	1.41** [1.13–1.77]	1.36* [1.05–1.75]	1.08 [0.81–1.43]	1.15 [0.91–1.44]	1.21 [0.96–1.52]	1.01 [0.81–1.25]	1.05 [0.85–1.29]
HIV- status	1.72*** [1.39–2.13]	1.87*** [1.53–2.30]	1.82*** [1.43–2.30]	1.51** [1.16–1.96]	0.87 [0.71–1.07]	0.97 [0.78–1.19]	0.94 [0.77–1.14]	1.02 [0.84–1.23]
Female	0.76*** [0.65–0.88]	0.73*** [0.64–0.83]	0.63*** [0.55–0.73]	0.66*** [0.56–0.77]	0.83** [0.73–0.95]	0.86* [0.74–0.99]	0.87* [0.76–0.99]	0.75*** [0.66–0.85]
Age categories (Ref: 18–25)	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
26–35 years old	1.16 [0.97–1.39]	1.03 [0.86–1.23]	1.04 [0.85–1.28]	1.04 [0.83–1.32]	0.84 [0.69–1.03]	0.80* [0.65–0.98]	0.87 [0.72–1.06]	0.84 [0.70–1.02]
36–45 years old	1.66*** [1.37–2.02]	1.37** [1.13–1.65]	1.14 [0.92–1.40]	1.08 [0.85–1.37]	0.62*** [0.50–0.76]	0.51*** [0.41–0.62]	0.88 [0.72–1.06]	0.60*** [0.50–0.73]
46–80 years old	3.02*** [2.24–4.08]	2.84*** [2.32–3.46]	2.63*** [2.16–3.21]	2.08*** [1.67–2.59]	0.45*** [0.37–0.54]	0.39*** [0.32–0.47]	0.76** [0.64–0.92]	0.43*** [0.36–0.52]
Education (Ref: None)	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Primary education	1.06 [0.81–1.39]	1.18 [0.96–1.47]	1.36** [1.11–1.67]	1.15 [0.92–1.44]	1.59*** [1.32–1.91]	1.52*** [1.27–1.82]	1.27** [1.07–1.52]	1.83*** [1.52–2.20]
Secondary or more education	1.72*** [1.28–2.32]	1.87*** [1.47–2.39]	1.89*** [1.49–2.40]	1.68*** [1.30–2.19]	2.49*** [1.99–3.13]	2.39*** [1.90–3.00]	1.97*** [1.59–2.45]	3.38*** [2.71–4.21]
Married/cohabiting	1 [0.85–1.17]	1.15 [0.99–1.33]	1.03 [0.89–1.20]	0.97 [0.82–1.15]	1.30*** [1.12–1.49]	1.34*** [1.16–1.55]	1.14 [1.00–1.31]	1.46*** [1.27–1.67]
Observations	4423	5277	5432	5406	5880	6073	6079	6073
Number of clusters	3103	3664	3851	3894	4100	4170	4173	4170
Community fixed effects	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Interviewer fixed effects	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes

Notes: AOR, adjusted odds ratio; 95% CI, 95% confidence interval. Logistic regression models included HIV status and HIV-1 viral load, gender, age categories, education categories, marital status, community fixed effects, and interviewer fixed effects. For each of the target ages of 50, 60, 70, and 80 years, the sample was limited to participants who were younger than the target age. 95% confidence intervals calculated using robust standard errors clustered at the individual level are reported in brackets.

*p < .05.

**p < .01.

***p < .001.

Appendix Table 1A. Unadjusted logistic regression results using pooled data from baseline and follow-up.

	50 years	60 years	70 years	80 years	Health in 1 year	Health in 3 years	Standard of living in this community in 1 year	Household financial well-being in 3 years
	OR [95% CI]	OR [95% CI]	OR [95% CI]	OR [95% CI]	OR [95% CI]	OR [95% CI]	OR [95% CI]	OR [95% CI]
Follow-up year 1 indicator variable	1.34*** [1.18–1.51]	1.45*** [1.30–1.62]	1.40*** [1.25–1.57]	1.37*** [1.21–1.55]	1.44*** [1.29–1.60]	1.38*** [1.24–1.54]	1.37*** [1.24–1.52]	1.32*** [1.20–1.46]
HIV status and viral load
Ref: HIV+, detectable viral load	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
HIV+, undetectable viral load	1.34** [1.10–1.65]	1.50*** [1.22–1.83]	1.40** [1.11–1.76]	1.17 [0.91–1.50]	1.02 [0.84–1.24]	1.03 [0.85–1.25]	0.93 [0.78–1.12]	0.91 [0.75–1.09]
HIV status	1.70*** [1.41–2.05]	1.94*** [1.62–2.33]	1.92*** [1.55–2.37]	1.61*** [1.28–2.03]	1.01 [0.85–1.20]	1.09 [0.91–1.30]	1.14 [0.96–1.35]	1.10 [0.92–1.30]
Observations	4433	5289	5438	5516	5889	6086	6086	6086
Number of clusters	3108	3670	3854	3944	4105	4177	4177	4177

Notes: OR, odds ratio; 95% CI, 95% confidence interval. Logistic regression models included an indicator variable for follow-up year 1 and controls for HIV status and HIV-1 viral load. For each of the target ages of 50, 60, 70, and 80 years, the sample was limited to participants who were younger than the target age. Ninety-five percentage confidence intervals calculated using robust standard errors clustered at the individual level are reported in brackets.

**p < .01.

***p < .001.

Appendix Table 2. Linear probability models with individual fixed effects.

	Very likely or almost certain to survive to				Very likely or almost certain to have better
	50 years	60 years	70 years	80 years	Health in 1 year	Health in 3 years	Standard of living in this community in 1 year	Household financial well-being in 3 years
	Coef. [95% CI]	Coef. [95% CI]	Coef. [95% CI]	Coef. [95% CI]	Coef. [95% CI]	Coef. [95% CI]	Coef. [95% CI]	Coef. [95% CI]
Follow-up year 1 indicator variable	0.19**	0.34***	0.24***	0.21**	0.30***	0.29***	0.27***	0.20**
	[0.06–0.31]	[0.22–0.46]	[0.11–0.37]	[0.07–0.36]	[0.17–0.43]	[0.15–0.43]	[0.13–0.41]	[0.07–0.34]
HIV status and viral load (Ref: HIV+, detectable viral load)	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
HIV+, undetectable viral load * Year 1	−0.16	−0.19*	−0.13	−0.07	−0.11	−0.12	−0.27**	−0.06
	[−0.34–0.01]	[−0.35–−0.03]	[−0.30–0.05]	[−0.27–0.12]	[−0.29–0.07]	[−0.30–0.07]	[−0.46–−0.08]	[−0.24–0.12]
HIV- status * Year 1	−0.03	−0.13	−0.02	−0.06	−0.12	−0.10	−0.01	−0.06
	[−0.18–0.12]	[−0.27–0.00]	[−0.17–0.13]	[−0.22–0.11]	[−0.27–0.03]	[−0.26–0.06]	[−0.17–0.15]	[−0.21–0.09]
Number of observations	2,928	3,550	3,436	3,406	3,902	4,180	4,180	4,180
Number of individuals	1,464	1,775	1,718	1,703	1,951	2,090	2,090	2,090

Abbreviations: Coef., coefficient; 95% CI, 95% confidence interval. Linear regression models included indicator variable for follow-up year 1, indicator variables for baseline HIV/viral load status, and an interaction between these variables and year 1. Sample was restricted to participants who answered questions in each wave. P-values notation: ***p < 0.001, **p <0.01.