Rapid initiation of antiretroviral therapy in those with newly diagnosed HIV infection in London, UK

HIV Med. 2019 Nov;20(10):699-703. doi: 10.1111/hiv.12780. Epub 2019 Aug 19.

Abstract

Objectives: In July 2016, as a result of patient demand, we introduced a rapid initiation option (RIO) to offer a first medical appointment and antiretroviral therapy (ART) initiation within 2 days of HIV diagnosis at 56 Dean Street (56DS) , a combined sexual health and HIV treatment service in London, UK.

Methods: We performed a retrospective case-note review of patients newly diagnosed with HIV infection at 56DS following the introduction of the new RIO from July to October 2016. In order to assess the effect of the new service on ART uptake, we chose a comparison group of newly diagnosed patients at 56DS from 1 year earlier: July to October 2015.

Results: In the 4 months following RIO introduction, there was a reduction in the median time from HIV diagnosis to the first medical appointment (7 versus 15 days; P < 0.00001) and to ART initiation (8 versus 21 days; P < 0.00001) compared with the same 4-month period 1 year previously. Uptake of ART at first appointment also significantly increased from 60% to 76% (P = 0.0074).

Conclusions: By increasing our clinic capacity and awareness of staff and patients of the RIO service, we were able to fulfil the aim of the service to offer ART more quickly following HIV diagnosis.

Keywords: HIV; antiretroviral therapy.

MeSH terms

  • Adult
  • Aged
  • Antiretroviral Therapy, Highly Active / statistics & numerical data*
  • Delivery of Health Care / standards*
  • Female
  • HIV Infections / drug therapy*
  • Humans
  • London
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data
  • Retrospective Studies