Feasibility of implementing same-day antiretroviral therapy initiation during routine care in Ekurhuleni District, South Africa: Retention and viral load suppression

Southern African Journal of HIV Medicine

Field Value
Title Feasibility of implementing same-day antiretroviral therapy initiation during routine care in Ekurhuleni District, South Africa: Retention and viral load suppression
Creator Mshweshwe-Pakela, Nolundi Hansoti, Bhakti Mabuto, Tonderai Kerrigan, Deanna Kubeka, Griffiths Hahn, Elizabeth Charalambous, Salome Hoffmann, Christopher J.
Subject HIV medicine; Primary health care HIV testing; primary care; SDI; ARV initiation; implementation
Description Background: Same-day initiation (SDI) of antiretroviral therapy (ART) has been advocated as an approach to increase linkage to care and overall ART initiation. Clinical trials have demonstrated impressive benefits. However, questions regarding patient preparedness and retention in care remain for routine implementation of this approach.Objectives: In this study, we sought to describe SDI of ART during routine care delivery and compare time to ART initiation on longitudinal care outcomes.Method: We performed a retrospective chart review of 100 consecutive individuals, newly diagnosed with HIV, from 10 health facilities across Ekurhuleni, from January to July 2017. Records were reviewed for a period of 1 year post-diagnosis. Abstracted data included demographics, time to ART initiation, clinic visits and laboratory test results (including viral load testing).Results: A total of 993 patient records were reviewed, of which 826 were included in the analysis. The majority of patients (752, 91%) had ART initiation recorded, of which 654 (79%) had ART initiated within 30 days, and 224 (27%) had SDI. Uptake of SDI of ART was higher among women (36% vs. 10.4%; p 0.001) and in younger patients (33.7% in those 29 years; p 0.01). Retention in care at 6 months was achieved in 477 (58%) patients. Of those with 6-month viral loads, 350/430 (73%) had a viral load 400 c/m. Retention in care and viral suppression were similar among those with SDI of ART and later ART initiation.Conclusion: Same-day initiation of ART was successfully delivered with similar retention and viral load outcomes as subsequent initiation, providing re-assurance for scale-up of this strategy in routine care.
Publisher AOSIS
Contributor Project SOAR (Supporting Operational AIDS Research), Cooperative Agreement AID-OAA-A-14-00060
Date 2020-08-20
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Retrospective chart review
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajhivmed.v21i1.1085
Source Southern African Journal of HIV Medicine; Vol 21, No 1 (2020); 6 pages 2078-6751 1608-9693
Language eng
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https://sajhivmed.org.za/index.php/hivmed/article/view/1085/1964 https://sajhivmed.org.za/index.php/hivmed/article/view/1085/1963 https://sajhivmed.org.za/index.php/hivmed/article/view/1085/1965 https://sajhivmed.org.za/index.php/hivmed/article/view/1085/1962
Coverage Ekurhuleni District; South Africa — Age; gender; time to ART initiation; Viral Loads
Rights Copyright (c) 2020 Nolundi Mshweshwe-Pakela, Bhakti Hansoti, Tonderai Mabuto, Deanna Kerrigan, Griffiths Kubeka, Elizabeth Hahn, Salome Charalambous, Christopher J. Hoffmann https://creativecommons.org/licenses/by/4.0