ABSTRACT
BACKGROUND:
The UNAIDS 2020 Global strategy to reduce the
transmission of
HIV includes ensuring
HIV viral load (VL) testing coverage of at least 90% on all
patients on antiretroviral
therapy (
ART). Routine VL
monitoring has been shown to result in earlier
detection of
treatment failure, timely regimen switches, promotion of adherence to
treatment and improved
survival. We wanted to assess the introduction of the wellness
anniversary in improving routine
viral load monitoring.
OBJECTIVES:
We retrospectively assessed effects of the wellness
anniversary on routine VL coverage, timeliness and
suppression rates.
METHOD:
The month when the
patient initiated
ART was designated as the wellness
anniversary. On the
anniversary month a package of care, which included a routine VL, was delivered. We conducted a retrospective chart audit to assess VL coverage and timeliness between two
time periods, from January 2016 to December 2016 (pre-implementation) and from January 2017 to December 2017 (post-implementation).
RESULTS:
Timeliness of VL testing improved from 27.5% in the pre-implementation cohort to 49.7% in the post-implementation cohort. Our study showed high VL testing coverage before the implementation of the wellness
anniversary with an average of 98.3% VL. There was a significant correlation between timeliness and VL
suppression (VLS) in the post-implementation group.
CONCLUSION:
Implementation of the wellness
anniversary may improve timeliness of routine VL testing in settings with high VL coverage. Studies looking at the effect of timeliness on VLS and clinical outcomes are needed.