Same-Day Medical Visit Increases Viral Suppression, Peter Ho Memorial Clinic, 2014-2015 and 2016-2017

J Assoc Nurses AIDS Care. 2019 May-Jun;30(3):292-300. doi: 10.1097/JNC.0000000000000052.

Abstract

Viral suppression (VS) in patients newly diagnosed with HIV is critical to reducing morbidity, mortality, and new transmissions. Rapid initiation of antiretroviral therapy (ART) is a promising model to improve VS, but patients must be seen expeditiously by a prescribing provider. Our retrospective study compared patients achieving VS after introduction of medical visits on the same day as HIV diagnoses from 2014 to 2017. The time to VS was evaluated using survival analysis. Wilcoxon two-sample tests evaluated median times to VS (after diagnosis and ART receipt). When 2016-2017 was compared with 2014-2015, a higher proportion of patients achieved VS (96% and 90%, respectively; p = .0292); the median time to VS decreased to 88 from 101 days after diagnosis and to 44 from 70 days after receipt of ART. As clinicians consider rapid ART initiation, a medical visit on the same day as HIV diagnosis is an intermediate intervention that may improve VS.

MeSH terms

  • Adult
  • Ambulatory Care / statistics & numerical data*
  • Ambulatory Care Facilities
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active*
  • CD4 Lymphocyte Count
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Infections / virology
  • Humans
  • Male
  • Middle Aged
  • Point-of-Care Testing / statistics & numerical data
  • Primary Health Care / methods*
  • Retrospective Studies
  • Time Factors
  • Time-to-Treatment*
  • Treatment Outcome
  • United States / epidemiology
  • Viral Load / drug effects*

Substances

  • Anti-HIV Agents