Early initiation of antiretroviral therapy (ART): from point-of-care test to ART at a peer-led community-based testing site in Sydney
R. Houghton A D , V. Knight A B , B. Clifton B C and R. Varma A BA Sydney Sexual Health Centre, Sydney/Sydney Eye Hospital, Sydney, NSW 2000, Australia.
B Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia.
C ACON Sydney, Australia.
D Corresponding author. Email: rebecca.houghton1@health.nsw.gov.au
Sexual Health 16(1) 94-95 https://doi.org/10.1071/SH18094
Submitted: 7 May 2018 Accepted: 5 July 2018 Published: 2 November 2018
Abstract
The effect of performing baseline HIV investigations (BLHIVI) at the time of a reactive HIV point-of-care test in the pathway to antiretroviral therapy (ART) in a community setting has not been described. In this study, 67 men newly diagnosed with HIV across three service models were analysed. The median time to ART was 30, 29.5 and 38 days (P = 0.29) at a peer-led community testing site intervention group, in a historical control group and in an urban publicly funded sexual health service respectively. In a community setting, the inclusion of BLHIVI has the potential to reduce the time to early ART initiation.
Additional keywords: HIV, investigations, operational research, treatment.
References
[1] World Health Organization. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. 2015. Available online at: http://www.who.int/hiv/pub/guidelines/earlyrelease-arv/en/ [verified 17 April 2018].[2] NSW Health. NSW HIV Strategy (2016–2020). 2015. Available online at: http://www.health.nsw.gov.au/endinghiv/Publications/nsw-hiv-strategy-2016-2020.PDF [verified 17 April 2018].
[3] The INSIGHT START Study Group. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med 2015; 373 795–807.
| Initiation of antiretroviral therapy in early asymptomatic HIV infection.Crossref | GoogleScholarGoogle Scholar |
[4] Pilcher CD, Ospina-Norvell C, Dasgupta A, Jones D, Hartogensis W, Torres S, Calderon F, Demicco E, Geng E, Gandhi M, Halvir DV, Hatano H. The effect of same-day observed initiation of antiretroviral therapy on HIV viral load and treatment outcomes in a US public health setting. J Acquir Immune Defic Syndr 2017; 74 44–51.
| The effect of same-day observed initiation of antiretroviral therapy on HIV viral load and treatment outcomes in a US public health setting.Crossref | GoogleScholarGoogle Scholar |
[5] Whitlock G, Blackwell S, Carbonell M, Patel S, Suchak T, Mohabeer M, Toby M, Barber T, Nwokolo N, McOwan A. Rapid initiation of antiretroviral treatment in newly diagnosed HIV: experience of a central London clinic. Proceedings of the 23rd Annual Conference of the British HIV Association; 4–7 April 2017; Liverpool, UK. London: British HIV Association; 2017. Abstract O14.
[6] Hoenigl M, Chaillon A, Moore DJ, Morris SR, Mehta SR, Gianella S, Amico KR, Little SJ. Rapid HIV viral load suppression in those initiating antiretroviral therapy at first visit after HIV diagnosis. Sci Rep 2016; 6 32947
| Rapid HIV viral load suppression in those initiating antiretroviral therapy at first visit after HIV diagnosis.Crossref | GoogleScholarGoogle Scholar |
[7] NSW Government. HIV/AIDS control guideline. Control guideline for public health units. 2004 Available online at: http://www.health.nsw.gov.au/Infectious/controlguideline/Pages/hiv-aids.aspx [verified 4 May 2018].