Background: Disengagement from HIV care reduces viral suppression, underscoring the need for rapid antiretroviral therapy (ART) access for people with known HIV diagnoses who have experienced lapses in care or face treatment interruption (e.g., from loss of insurance, relocation). Evidence on rapid ART restart outcomes remains limited. Methods: We evaluated the rapid ART restart program at the nurse-led San Francisco AIDS Foundation sexual health center, which serves clients with known HIV diagnoses (on ART, off ART, or ART-naïve), using electronic medical records and the San Francisco Department of Public Health surveillance data. We assessed viral suppression (VS: <200 copies/mL) achieved or maintained within 365 days. Provider and staff interviews contextualized findings. Findings: Between October 2016-March 2020, 260 individuals presented to the program (median age 34 years; 97% male; 34% Hispanic; 8% Black): 73% on ART, 23% ART-experienced but off ART, and 4% ART naïve. Providers noted that rapid ART restart visits are time-intensive because clients present with complex histories and multiple needs. Reasons for presentation included loss of insurance (58%), relocation (37%), and STD services (17%). Needs included ART prescriptions (92%), labs (67%), health navigation (65%), and insurance support (61%). Of 239 individuals requesting ART, 99% received prescriptions. VS was maintained by 76% of those on ART and demonstrated by 66% off ART and 90% ART-naïve. Conclusion: A nurse-led sexual health center effectively bridged HIV care gaps by providing immediate ART access and comprehensive support, though VS estimates for treatment-experienced individuals, while in line with existing literature, highlight the need for continued research to improve VS outcomes.
Tourneau et al. (Thu,) studied this question.