Entering HIV Medical Care with AIDS in the Era of Immediate Access to Antiretroviral Treatment.

Background: Despite advancements in rapid HIV care access, a significant portion of people living with HIV (PLWH) still enter care with advanced disease (AIDS). Test and Treat/ Rapid Access (TTRA) programs focused on rapid detection and treatment are widespread in the US. However, a significant proportion of patients enter care through the traditional standard of care where, after a case manager evaluation an initial appointment is generated for an HIV provider, a process that could take 2-4 weeks.

Objectives: This study conducted at the University of Miami/JMH (UM/JMH) Adult HIV Outpatient Clinic-the largest single-site clinic in Miami Dade, a central hub of the HIV epidemic-analyzes individuals that enrolled during the initial two years of our TTRA program.

Methods: We compared the clinical outcomes of patients diagnosed with AIDS entering through the TTRA versus those using the Standard of Care (SOC).

Results: Our findings indicate substantial improvements in HIV viral loads and CD4 counts for both groups. However, patients entering through SOC, who were more likely to have had prior hospitalizations due to opportunistic infections, tended to be older and predominantly contracted HIV through heterosexual transmission. In contrast, those entering TTRA experienced quicker virologic suppression and superior immunologic recovery.