ArticleJournal of acquired immune deficiency syndromes (1999)2025
Outcomes of Rapid Restart Among People With Previously Diagnosed HIV at a Safety-Net HIV Clinic in San Francisco.
Article in Journal of acquired immune deficiency syndromes (1999), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLittle is known about outcomes of rapid restart of antiretroviral therapy (ART) among people with HIV relinking to care.
settingSafety-net HIV clinic in San Francisco.
methodsUsing electronic medical record data, we conducted a retrospective study of adults with HIV (≥18 years old, out of care, self-reported off ART) seen for rapid (same-day) restart of ART. Descriptive statistics summarized baseline sociodemographic and clinical variables. χ 2 and Fisher exact tests assessed associations between sociodemographic or clinical variables and 2 primary outcomes: (1) viral suppression (VS) [HIV viral load (VL) <200 copies/mL] within 180 days and (2) sustained re-engagement in care (≥1 primary care provider visit both within 90 and 91-180 days after rapid restart). Complete case VS analysis included those with baseline viremia and follow-up HIV VLs. In sensitivity analysis, those with missing follow-up VLs were considered nonsuppressed.
resultsBetween August 2020-October 2023, 141 adults (median age 42; 85% cis-male; 26% Latino/a) presented for rapid restart. Housing instability/homelessness (46%), substance use (61%), and mental illness (49%) were common. Among those with baseline viremia who returned for follow-up VLs, VS was attained in 79% and associated significantly with non-Latino/a ethnicity (87% non-Latino/a vs. 57% Latino/a, P = 0.004). However, VS was 58% when considering missing follow-up VLs as nonsuppressed. Sustained re-engagement in care was observed in only 33%.
conclusionAfter rapid restart, sustained re-engagement in care and VS were low. Evaluation of key processes of rapid restart, retention efforts, and studies on effective re-engagement support strategies are needed.
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