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Objectives:

Among HIV-1-infected individuals in Africa, coinfection with malaria and diarrhoeal disease may be associated with more rapid HIV-1 disease progression. We sought to determine whether the use of long-lasting insecticide-treated bed nets and simple point-of-use water filters can delay HIV-1 disease progression.

Design:

A prospective cohort study.

Setting:

Two HIV care sites in Kenya.

Participants:

HIV-1-infected adults not yet meeting criteria for antiretroviral therapy.

Interventions:

One group received the standard of care, whereas the other received long-lasting insecticide-treated bed nets and water filters. Individuals were followed for up to 24 months.

Main outcome measures:

The primary outcome measures were time to CD4 cell count less than 350 cells/μl and a composite endpoint of time to CD4 cell count less than 350 cells/μl and nontraumatic death. Time to disease progression was compared using …