The Cooperative Re-Engagement Controlled Trial (CoRECT): Durable Viral Suppression Assessment.
J Acquir Immune Defic Syndr
; 93(2): 134-142, 2023 06 01.
Article
em En
| MEDLINE
| ID: mdl-36812382
ABSTRACT
BACKGROUND:
A collaborative, data-to-care strategy to identify persons with HIV (PWH) newly out-of-care, combined with an active public health intervention, significantly increases the proportion of PWH re-engaged in HIV care. We assessed this strategy's impact on durable viral suppression (DVS).METHODS:
A multisite, prospective randomized controlled trial for out-of-care individuals using a data-to-care strategy and comparing public health field services to locate, contact, and facilitate access to care versus the standard of care. DVS was defined as the last viral load, the viral load at least 3 months before, and any viral load between the 2 were all <200 copies/mL during the 18-month postrandomization. Alternative definitions of DVS were also analyzed.RESULTS:
Between August 1, 2016-July 31, 2018, 1893 participants were randomized from Connecticut (n = 654), Massachusetts (n = 630), and Philadelphia (n = 609). Rates of achieving DVS were similar in the intervention and standard-of-care arms in all jurisdictions (all sites 43.4% vs 42.4%, P = 0.67; Connecticut 46.7% vs 45.0%, P = 0.67; Massachusetts 40.7 vs 44.4%, P = 0.35; Philadelphia 42.4% vs 37.3%, P = 0.20). There was no association between DVS and the intervention (RR 1.01, CI 0.91-1.12; P = 0.85) adjusting for site, age categories, race/ethnicity, birth sex, CD4 categories, and exposure categories.CONCLUSION:
A collaborative, data-to-care strategy, and active public health intervention did not increase the proportion of PWH achieving DVS, suggesting additional support to promote retention in care and antiretroviral adherence may be needed. Initial linkage and engagement services, through data-to-care or other means, are likely necessary but insufficient for achieving DVS for all PWH.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Pregnancy
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Acquir Immune Defic Syndr
Ano de publicação:
2023
Tipo de documento:
Article