Timely initiation of HIV antiretroviral therapy in Haiti 2004 2018
A retrospective cohort study
Bibliographic Data
Objective. To describe trends in timing of ART initiation for newly diagnosed people living with HIV before and after Haiti adopted its Test and Start policy for universal HIV antiretroviral therapy (ART) in July 2016, and to explore predictors of timely ART initiation for both newly and previously diagnosed people living with HIV following Test and Start adoption. Methods. This retrospective cohort study explored timing of ART initiation among 147 900 patients diagnosed with HIV at 94 ART clinics in 2004–2018 using secondary electronic medical record data. The study used survival analysis methods to assess time trends and risk factors for ART initiation. Results. Timely uptake of ART expanded with Test and Start, such that same-day ART initiation rates increased from 3.7% to 45.0%. However, only 11.0% of previously diagnosed patients initiated ART after Test and Start. In adjusted analyses among newly diagnosed people living with HIV, factors negatively associated with timely ART initiation included being a pediatric patient aged 0–14 years (HR = 0.23, p p = 0.03), being 50+ years (HR = 0.87, p = 0.03), being underweight (HR = 0.79, p p p Conclusions. Haiti has made substantial progress in scaling up Test and Start, but further work is needed to enroll previously diagnosed patients and to ensure rapid ART in key patient subgroups. Further research is needed on facility and geographic factors and on strategies for improving timely ART initiation among vulnerable subgroups
Antiretroviral therapy · Body mass index · Cohort · Family medicine · Human immunodeficiency virus (HIV · Overweight · Retrospective cohort study · Underweight · Viral load · HIV Research and Treatment · HIV/AIDS drug development and treatment · HIV/AIDS Research and Interventions · Medicine · Internal Medicine · Pediatrics · Surgery
Applied Survival Analysis
A theory of organizational readiness for change
Fostering implementation of health services research findings into practice
Diffusion of Innovations in Service Organizations
Attrition from antiretroviral treatment services among pregnant and non-pregnant patients following adoption of Option B+ in Haiti
Success factors for implementing and sustaining a mature electronic medical record in a low-resource setting
| Citation velocity | historical |
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| Highly cited | No |