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Lessons learned from U.S. rapid antiretroviral therapy initiation programs

Citation

Doshi RK, Hull S, Broun A, et al. Lessons learned from U.S. rapid antiretroviral therapy initiation programs. Int J STD AIDS. 2023;34(13):945-955. doi:10.1177/09564624231185622

Implementation stage:

Implementation

Implementation outcomes reported:

Not applicable

Continuum target addressed:

ART initiation, HIV diagnosis

Geography:

Non-priority jurisdiction

Study Participant Classification:

Providers, Implementer(s)

Plain Language Objectives

The researchers interviewed leaders of nine US HIV clinics that had already introduced rapid treatment. They wanted to learn what helped clinics begin medication quickly and what logistical, emotional, and financial challenges other programs should anticipate.

Plain Language Abstract

Although rapid antiretroviral therapy has been recommended for years, many US clinics have not adopted it. Researchers conducted semistructured interviews with medical leaders from nine clinics that were early implementers. Using an implementation framework, they identified three central areas: confidence in the scientific evidence, support from multiple stakeholders, and the compressed treatment timeline. Immediate access to medication and broad staff buy-in helped implementation. Leaders said patients responded better when clinicians introduced rapid treatment with empathy and addressed other needs alongside a new HIV diagnosis. The shortened timeline could create logistical pressure, but it also offered opportunities to build strong early relationships between patients and providers. Programs needed to plan for medication costs, clinic workflow, and mixed emotional reactions to diagnosis. These findings represent leaders’ lessons from nine experienced clinics, not a comparison of rapid and conventional treatment. The qualitative study did not independently measure time to treatment or clinical outcomes and cannot determine which implementation components caused program success.

Key Takeaways

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Publications

Barriers/Facilitators

Science Frameworks

Implementation Science Frameworks

Outcomes

Community Partnerships

Welcome to the Dashboard

This dashboard provides an accessible way to explore national and jurisdictional findings from implementation science research supporting the Ending the HIV Epidemic initiative. The homepage gives you quick access to major sections of the site and highlights key insights drawn from ongoing research and community partnerships.

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  • About explains the purpose of the dashboard, the research framework guiding this project, and how to interpret the data and publications included here.
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