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RAPID START LEADS TO SUSTAINED VIRAL
SUPPRESSION IN YOUNG PEOPLE IN THE SOUTH
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CROI 2020
Reported by Jules Levin
Lorna Seybolt1, Katherine Conner1, Isolde Butler1, Nicholas Van Sickels1, Jason Halperin1
1CrescentCare, New Orleans, LA, USA
Newly diagnosed patients were linked within 72 hours of diagnosis (often same-day) to CrescentCare, a Federally Qualified Health Center in New Orleans. The first dose was directly observed and patients were provided a 30-day dose pack.
program abstract
RAPID START LEADS TO SUSTAINED VIRAL SUPPRESSION IN YOUNG PEOPLE IN THE SOUTH
Lorna Seybolt1, Katherine Conner1, Isolde Butler1, Nicholas Van Sickels1, Jason Halperin1
1CrescentCare, New Orleans, LA, USA
Background: HIV incidence continues to increase in young men of color. Youth living with HIV, also, have lower rates of viral suppression and retention in care. Rapid Start is a linkage-to-care intervention to start people newly diagnosed with HIV immediately on ART and support equity in care. Our prior data has shown that rapid ART initiation improves linkage and viral suppression. Rapid Start data for US youth has not been published. To verify that youth were achieving similar outcomes, we developed a continuum of care for our young adult rapid start population and compared this continuum to our adult population.
Methods: Newly diagnosed patients were linked within 72 hours of diagnosis (often same-day) to CrescentCare, a Federally Qualified Health Center in New Orleans. The first dose was directly observed and patients were provided a 30-day dose pack. Labs were drawn and patients underwent expedited insurance enrollment. The proportion achieving viral suppression, time to viral suppression, sustained viral suppression 12 months post-diagnosis and engagement in care at 12 months were compared between youth (18 – 24) and adults.
Results: 124 patients were enrolled in our rapid start intervention between 12/1/2016 and 5/15/2018. Ninety-three were 25 or older with a median age of 33. Thirty-one were under 25 with a median age of 21. All patients chose to start ART, and none stopped due to adverse effects. 96.8% (30/31) of the youth population achieved viral suppression with a median of 29 days from diagnosis. 83.9% (26/31) remained virally suppressed at 12 months post-diagnosis and 96.8% (30/31) remained engaged in care.
97.9% (91/93) of the adult population achieved viral suppression with a median of 28 days from diagnosis. 92.5% (86/93) remained virally suppressed at 12 months post-diagnosis and 97.9% (91/93) remained engaged in care. There were no significant differences in these outcomes between the two groups.
Conclusion: The intervention outcomes demonstrate that starting adults and youth on ART immediately after diagnosis, before labs are obtained, is safe, well-tolerated, and effective. Viral suppression was quickly achieved and maintained. Rapid Start is a paradigm shift that upholds equity and effectively engages youth.
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