Impact of Rapid ART Initiation on Retention in Care in the Southern US

NCT ID: NCT04266938

Last Updated: 2025-08-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

258 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-06-01

Study Completion Date

2024-05-30

Brief Summary

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Impact of Rapid ART Initiation on Retention in Care in the Southern US

Specific Goals and Aims:

The major goal for this study is to determine if rapid start of antiretroviral (ART) therapy increases retention in HIV medical care. The investigators hypothesize that there will be an increase in retention in care with rapid start, by removing barriers that would normally delay enrollment in a treatment program and enforce the importance of linkage to care and ART initiation from diagnosis.

In order to test this hypothesis, the investigators have the following specific aims for their proposed study:

1. Study retention in care after rapid ART start in comparison to standard of care.
2. Analyze risk factors for decreased retention in care, with focus on high-risk populations.
3. Analyze potential demographic and geographic determinants of retention in care.
4. Generate retention in care data in a Southern US state.

The investigators hypothesize the introduction of rapid start ART, as well as the introduction of care navigators, will lead to improved clinical outcomes, including retention in care at one year, viral suppression at one year, time to viral suppression, and time to first missed appointment. In the event rapid start ART fails to have a positive impact on clinical outcomes, the results of this study will still positively contribute to the knowledge gap, since there is a scarcity of data in the Southern United States, specifically in high-risk populations, such as racial and ethnic minorities, youth, and patients co-infected with hepatitis C.

Detailed Description

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Conditions

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HIV-1-infection

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Prospective RAPID

The prospective RAPID arm will include all patients who meet inclusion criteria and who start BIC/F/TAF within 7 days of HIV diagnos

Group Type ACTIVE_COMPARATOR

Rapid start of antiretrovirals

Intervention Type BEHAVIORAL

Utilize health navigators to link patients with newly diagnosed HIV into care and treatment within 7 days

Prospective Non- RAPID

The prospective non-RAPID arm will include all patients identified as having new HIV diagnosis per health department records, but who failed to establish care at the 550 Clinic and begin BIC/F/TAF within one week of diagnosis

Group Type ACTIVE_COMPARATOR

Non- RAPID start

Intervention Type BEHAVIORAL

Review of patients who failed to establish care and start ART within 7 days of HIV diagnosis and analyze impact on retention in care.

Retrospective Non- RAPID

The retrospective Non-RAPID arm will include historic controls who enrolled in the treatment program from 2012, when universal ART guidelines were implemented, until prior to the implementation of RAPID start of ART.

Group Type ACTIVE_COMPARATOR

Retrospective analysis

Intervention Type BEHAVIORAL

Review historical standard of care relative to time to start antiretrovirals and impact on retention in care.

Interventions

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Rapid start of antiretrovirals

Utilize health navigators to link patients with newly diagnosed HIV into care and treatment within 7 days

Intervention Type BEHAVIORAL

Retrospective analysis

Review historical standard of care relative to time to start antiretrovirals and impact on retention in care.

Intervention Type BEHAVIORAL

Non- RAPID start

Review of patients who failed to establish care and start ART within 7 days of HIV diagnosis and analyze impact on retention in care.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Prospective arms: Human subjects ≥18 years old, newly diagnosed with HIV who are establishing care at the 550 Clinic.
* Retrospective arm: Human subjects ≥18 years old, newly diagnosed with HIV who established care at the 550 Clinic and were treated with ART between 2012-2019.

Exclusion Criteria

* Pregnancy
* Prior HIV diagnosis or exposure to ART
* Medical necessity for therapy with ART agent other than bictegravir/emtricitabine/tenofovir alafenamide (BIC/F/TAF), such as drug allergy, drug-drug interactions, creatinine clearance \<30.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Louisville

OTHER

Sponsor Role lead

Responsible Party

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Bailey Benidir, PharmD

Clinical Pharmacist

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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550 Clinic

Louisville, Kentucky, United States

Site Status

Countries

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United States

Other Identifiers

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20.0017

Identifier Type: -

Identifier Source: org_study_id

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