Details

Autor(en) / Beteiligte

• Doshi, Rupali K
• Hull, Shawnika
• Broun, Aaron
• Boyani, Saanjh
• Moch, Darryl
• Visconti, Adam J
• Castel, Amanda D
• Baral, Stefan
• Colasanti, Jonathan
• Rodriguez, Allan E
• Jones, Joyce
• Coffey, Susa
• Monroe, Anne K

Titel

Lessons learned from U.S. rapid antiretroviral therapy initiation programs

Ist Teil von

• International journal of STD & AIDS, 2023-11, Vol.34 (13), p.945-955

Ort / Verlag

England

Erscheinungsjahr

2023

Quelle

MEDLINE

Beschreibungen/Notizen

• Rapid antiretroviral therapy initiation (R-ART) for treatment of HIV has been recommended since 2017, however it has not been adopted widely across the US. The study purpose was to understand facilitators and barriers to R-ART implementation in the U.S. This was a qualitative design involving semi-structured interviews. The study sample was comprised of the medical leadership of nine US HIV clinics that were early implementers of R-ART. In-depth, semi-structured interviews were performed. The Consolidated Framework for Implementation Research (CFIR) was used to guide thematic analysis. We identified three main content areas: strong scientific rationale for R-ART, buy-in from multiple key stakeholders, and the condensed timeline of R-ART. The CFIR construct of Evidence Strength and Quality was cited as an important factor in R-ART implementation. Buy-in from key stakeholders and immediate access to medications ensured the success of R-ART implementation. Patient acceptance of the condensed timeline for ART initiation was facilitated when presented in a patient-centered manner, including empathetic communication and addressing other patient needs concurrently. The condensed timeline of R-ART presented logistical challenges and opportunities for the development of intense patient-provider relationships. Results from the analysis showed that R-ART implementation should address the following: 1) logistical planning to implement HIV treatment with a condensed timeline 2) patients' mixed reactions to a new HIV diagnosis and 3) the high cost of HIV medications.