Lessons learned from U.S. rapid antiretroviral therapy initiation programs.
Int J STD AIDS
; 34(13): 945-955, 2023 11.
Article
em En
| MEDLINE
| ID: mdl-37461333
ABSTRACT
BACKGROUND:
Rapid antiretroviral therapy initiation (R-ART) for treatment of HIV has been recommended since 2017, however it has not been adopted widely across the US.PURPOSE:
The study purpose was to understand facilitators and barriers to R-ART implementation in the U.S. RESEARCHDESIGN:
This was a qualitative design involving semi-structured interviews. STUDY SAMPLE The study sample was comprised of the medical leadership of nine US HIV clinics that were early implementers of R-ART. DATA COLLECTION ANDANALYSIS:
In-depth, semi-structured interviews were performed. The Consolidated Framework for Implementation Research (CFIR) was used to guide thematic analysis.RESULTS:
We identified three main content areas strong scientific rationale for R-ART, buy-in from multiple key stakeholders, and the condensed timeline of R-ART. The CFIR construct of Evidence Strength and Quality was cited as an important factor in R-ART implementation. Buy-in from key stakeholders and immediate access to medications ensured the success of R-ART implementation. Patient acceptance of the condensed timeline for ART initiation was facilitated when presented in a patient-centered manner, including empathetic communication and addressing other patient needs concurrently. The condensed timeline of R-ART presented logistical challenges and opportunities for the development of intense patient-provider relationships.CONCLUSIONS:
Results from the analysis showed that R-ART implementation should address the following 1) logistical planning to implement HIV treatment with a condensed timeline 2) patients' mixed reactions to a new HIV diagnosis and 3) the high cost of HIV medications.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
Tipo de estudo:
Prognostic_studies
/
Qualitative_research
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article