Healthcare Providers' Perspectives on Same-Day Antiretroviral Initiation in Ethiopian Healthcare Facilities.

Abstract

Background: The concept of same-day antiretroviral therapy (ART) initiation entails initiating HIV treatment promptly upon diagnosis, ideally during the initial clinic visit or even on the same day as diagnosis. This study explores the factors leading to patient loss to follow-up after same-day ART initiation and the benefits and challenges associated with this approach.

Methods: A qualitative research design was employed to investigate healthcare providers' perspectives regarding same-day ART initiation and its contribution to patient loss to follow-up following same-day ART initiation, benefits, and challenges. It is a qualitative study conducted in the form of in-depth cell phone interviews with physicians and nurses who are providing ART services within healthcare facilities in Ethiopia. Data collection was conducted from April 30, 2021, to March 22, 2022.

Results: The findings revealed that same-day ART initiation offers both advantages and drawbacks. Findings show benefits such as shifts in perceptions and attitudes towards HIV, reduced transmission rates, enhanced service utilization, and viral suppression. However, disadvantages included its inappropriateness for critically ill patients' refusal to accept results and suboptimal adherence, leading to increased risk of patient loss to follow-up.

Conclusion: Same-day ART initiation presents a dual nature, offering immediate benefits in HIV management and transmission reduction, yet facing challenges regarding suitability for critically ill patients and adherence issues. The authors recommend addressing factors such as patient education, stigma reduction, and tailored interventions, which are crucial in optimizing the effectiveness of this approach and minimizing patient loss to follow-up.