Initiation of Antiretroviral Therapy in the Hospital Is Associated With Linkage to Human Immunodeficiency Virus (HIV) Care for Persons Living With HIV and Substance Use Disorder
Published by Oxford University Press for the Infectious Diseases Society of America 2020..
BACKGROUND: Studies have demonstrated benefits of antiretroviral therapy (ART) initiation on the day of human immunodeficiency virus (HIV) testing or at first clinical visit. The hospital setting is understudied for immediate ART initiation.
METHODS: CTN0049, a linkage-to-care randomized clinical trial, enrolled 801 persons living with HIV (PLWH) and substance use disorder (SUD) from 11 hospitals across the United States. This secondary analysis examined factors related to initiating (including reinitiating) ART in the hospital and its association with linkage to HIV care, frequency of outpatient care visits, retention, and viral suppression.
RESULTS: Of 801 participants, 124 (15%) initiated ART in the hospital, with more than two-thirds of these participants (80/124) initiating ART for the first time. Time to first HIV care visit among those who initiated ART in the hospital and those who did not was 29 and 54 days, respectively (P = .0145). Hospital initiation of ART was associated with increased frequency of HIV outpatient care visits at 6 and 12 months. There was no association with ART initiation in the hospital and retention and viral suppression over a 12-month period. Participants recruited in Southern hospitals were less likely to initiate ART in the hospital (P < .001).
CONCLUSIONS: Previous research demonstrated benefits of immediate ART initiation, yet this approach is not widely implemented. Research findings suggest that starting ART in the hospital is beneficial for increasing linkage to HIV care and frequency of visits for PLWH and SUD. Implementation research should address barriers to early ART initiation in the hospital.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:73 |
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| Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - 73(2021), 7 vom: 05. Okt., Seite e1982-e1990 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jacobs, Petra [VerfasserIn] |
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| Links: |
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| Themen: |
ART initiation |
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| Anmerkungen: |
Date Completed 20.10.2021 Date Revised 07.11.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/cid/ciaa838 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM311479162 |
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| 100 | 1 | |a Jacobs, Petra |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Initiation of Antiretroviral Therapy in the Hospital Is Associated With Linkage to Human Immunodeficiency Virus (HIV) Care for Persons Living With HIV and Substance Use Disorder |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Revised 07.11.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published by Oxford University Press for the Infectious Diseases Society of America 2020. | ||
| 520 | |a BACKGROUND: Studies have demonstrated benefits of antiretroviral therapy (ART) initiation on the day of human immunodeficiency virus (HIV) testing or at first clinical visit. The hospital setting is understudied for immediate ART initiation | ||
| 520 | |a METHODS: CTN0049, a linkage-to-care randomized clinical trial, enrolled 801 persons living with HIV (PLWH) and substance use disorder (SUD) from 11 hospitals across the United States. This secondary analysis examined factors related to initiating (including reinitiating) ART in the hospital and its association with linkage to HIV care, frequency of outpatient care visits, retention, and viral suppression | ||
| 520 | |a RESULTS: Of 801 participants, 124 (15%) initiated ART in the hospital, with more than two-thirds of these participants (80/124) initiating ART for the first time. Time to first HIV care visit among those who initiated ART in the hospital and those who did not was 29 and 54 days, respectively (P = .0145). Hospital initiation of ART was associated with increased frequency of HIV outpatient care visits at 6 and 12 months. There was no association with ART initiation in the hospital and retention and viral suppression over a 12-month period. Participants recruited in Southern hospitals were less likely to initiate ART in the hospital (P < .001) | ||
| 520 | |a CONCLUSIONS: Previous research demonstrated benefits of immediate ART initiation, yet this approach is not widely implemented. Research findings suggest that starting ART in the hospital is beneficial for increasing linkage to HIV care and frequency of visits for PLWH and SUD. Implementation research should address barriers to early ART initiation in the hospital | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a ART initiation | |
| 650 | 4 | |a HIV | |
| 650 | 4 | |a disorder | |
| 650 | 4 | |a hospital | |
| 650 | 4 | |a substance use | |
| 650 | 4 | |a treatment linkage | |
| 650 | 7 | |a Anti-HIV Agents |2 NLM | |
| 700 | 1 | |a Feaster, Daniel J |e verfasserin |4 aut | |
| 700 | 1 | |a Pan, Yue |e verfasserin |4 aut | |
| 700 | 1 | |a Gooden, Lauren K |e verfasserin |4 aut | |
| 700 | 1 | |a Daar, Eric S |e verfasserin |4 aut | |
| 700 | 1 | |a Lucas, Gregory M |e verfasserin |4 aut | |
| 700 | 1 | |a Jain, Mamta K |e verfasserin |4 aut | |
| 700 | 1 | |a Marsh, Eliza L |e verfasserin |4 aut | |
| 700 | 1 | |a Armstrong, Wendy S |e verfasserin |4 aut | |
| 700 | 1 | |a Rodriguez, Allan |e verfasserin |4 aut | |
| 700 | 1 | |a Del Rio, Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Metsch, Lisa R |e verfasserin |4 aut | |
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