Test, treat, and maintain: rapid initiation of antiretroviral therapy

Doshi, Rupali; Greenberg, Alan E.

doi:10.1097/qad.0000000000002994

Cited by 2 publications

(4 citation statements)

References 17 publications

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“…Additionally, same-day ART initiation is becoming increasingly utilized among newly diagnosed PWH regardless of the patient's HIV stage at diagnosis [29].…”

Section: Discussionmentioning

confidence: 99%

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HIV care continuum outcomes among recently diagnosed people with HIV (PWH) in Washington, DC

Jaurretche

Byrne²,

Happ³

et al. 2023

Epidemiol. Infect.

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The Ending the HIV Epidemic initiative aims to decrease new HIV infections and promote testand-treat strategies. Our aims were to establish a baseline of HIV outcomes among newly diagnosed PWH in Washington, DC (DC), a "hotspot" for the HIV epidemic. We also examined sociodemographic and clinical factors associated with retention in care (RIC), antiretroviral therapy (ART) initiation, and viral suppression (VS) among newly diagnosed PWH in the DC Cohort from 2011-2016.Among 455 newly diagnosed participants, 92% were RIC at 12 months, ART was initiated in 65% at 3 months and 91% at 12 months, VS in at least 17% at 3 months and 82% at 12 months, and 55%% of those with VS at 12 months had sustained VS for an additional 12 months. AIDS diagnosis was associated with RIC (aOR 2.99;1.13-2.28), ART initiation by 3 months (aOR 2.58; 1.61-4.12), and VS by 12 months (aOR4.87; 1.69-14.03). This analysis contributes to our understanding of the HIV treatment dynamics of persons with recently diagnosed HIV infection in a city with a severe HIV epidemic.

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“…Additionally, same-day ART initiation is becoming increasingly utilized among newly diagnosed PWH regardless of the patient's HIV stage at diagnosis [29].…”

Section: Discussionmentioning

confidence: 99%

“…Prompt identification and RIC of individuals with HIV are crucial steps to ensuring better clinical outcomes and preventing new HIV infections. Additionally, same-day ART initiation is becoming increasingly utilised among newly diagnosed PWH regardless of the patient's HIV stage at diagnosis [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

HIV care continuum outcomes among recently diagnosed people with HIV (PWH) in Washington, DC

Jaurretche

Byrne²,

Happ³

et al. 2023

Epidemiol. Infect.

View full text Add to dashboard Cite

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“…Structural issues can complicate Rapid ART implementation; access to ART and elements of linkage to care can differ state to state [ 28 ] and organizational readiness for implementation relies on multiple elements [ 29 , 30 ]. At the individual level, however, provider hesitancy may be rooted in a knowledge gap between the known of traditional ART initiation, and the unknown of what the Rapid ART model looks like in practice.…”

Section: Introductionmentioning

confidence: 99%

“…A 2015 dyadic study identified the patient-provider encounter as “a key factor in ART usage” [ 31 ],while other studies of HIV provider messaging and patient experience suggest that even a single conversation can make a big difference in the choices that patients make about their treatment [ 32 ]. Researchers studying Rapid ART specifically have stressed “a need for delivery of the message to start treatment tailored to the individual patient” [ 28 ]. That said, it is not well understood how staff and providers can cultivate this trust and connectedness within the unique context of the Rapid interaction.…”

Section: Introductionmentioning

confidence: 99%

The Rapid interaction: a qualitative study of provider approaches to implementing Rapid ART

Moran

Koester

Tourneau

et al. 2023

Implement Sci Commun

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Background Offering antiretroviral therapy (ART) to patients directly following an HIV diagnosis (“Rapid ART”) improves clinical outcomes and is feasible and acceptable for patients and providers. Despite this, implementation of Rapid ART is not yet standard practice in the USA. Structural-level implementation guidance is available, but research at the individual provider level that explores the patient-provider interaction itself remains scarce. The Consolidated Framework for Implementation Research (CFIR) provides a nuanced guide to investigating the less visible, more social elements of implementation like the knowledge and feelings of people, and the influences of culture and resources on individual approaches. Methods We conducted a multi-site qualitative study, exploring intervention commonalities across three HIV clinic environments: an HIV primary care clinic; an HIV/STI testing, treatment, and prevention clinic; and a large federally qualified health center (FQHC). Qualitative data were gathered from 27 provider informants—Rapid ART program staff and clinicians—using an interview guide developed using the CFIR. An experienced qualitative team conducted a comprehensive thematic analysis and identified cross-cutting themes in how providers approach and engage in the Rapid interaction, as well as longer-form narratives from providers that describe more fully what this interaction looks like for them. Results Three main themes represent the range and content of individual provider approaches to the Rapid interaction: (1) patient-centeredness; (2) emotional support and partnership; and (3) correcting misperceptions about HIV. Each theme encompassed both conceptual approaches to offering Rapid ART and concrete examples of messaging to the patient that providers used in the Rapid interaction. We describe and show examples of these themes, offer key take-aways for implementation, and provide expanded narratives of providers’ personal approaches to the Rapid interaction. Conclusions Exploration of provider-level approaches to Rapid ART implementation, as carried out in the patient-provider Rapid interaction, contributes a critical layer of evidence for wider implementation. It is our hope that, together with existing research showing positive outcomes and core components of systems-level implementation, these findings add to an instructive body of findings that facilitates the implementation of Rapid ART as an enhanced model of HIV care.

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Test, treat, and maintain: rapid initiation of antiretroviral therapy

Cited by 2 publications

References 17 publications

HIV care continuum outcomes among recently diagnosed people with HIV (PWH) in Washington, DC

HIV care continuum outcomes among recently diagnosed people with HIV (PWH) in Washington, DC

The Rapid interaction: a qualitative study of provider approaches to implementing Rapid ART

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