OBJECTIVE: The 'JumpstART' program in New York City (NYC) public Sexual Health Clinics (SHC) provides patients newly diagnosed with HIV with ART (one-month supply) on day of diagnosis and active linkage to HIV care (LTC). We examined viral suppression (VS) among patients who did and did not receive JumpstART services. DESIGN: Retrospective cohort. METHODS: Among newly diagnosed SHC patients (11/23/16-9/30/18) who were matched to the NYC HIV surveillance registry to obtain HIV laboratory test results through 06/30/19, we compared 230 JumpstART and 73 non-JumpstART patients regarding timely LTC (≤30 days), probability of VS (viral load < 200 copies/mL) by three months post-diagnosis, and time to and factors associated with achieving VS within the follow-up period. RESULTS: Of 303 patients, 76% (230/303) were JumpstART and the remaining were non-JumpstART patients; 36 (11%) had acute HIV infections. LTC ≤ 30 days was observed for 63% of JumpstART and 73% of non-JumpstART patients. By 3 months post-diagnosis, 83% of JumpstART versus 45% of non-JumpstART patients achieved VS (log-rank, p < .0001). Median times to VS among virally suppressed JumpstART and non-JumpstART patients were 31 (interquartile range: 24-51) and 95 days (IQR: 52-153), respectively. For groups with and without timely LTC, JumpstART was associated with viral suppression within 3 months post-diagnosis, after adjusting for age and baseline viral load. CONCLUSIONS: Prompt ART initiation among SHC patients, some with acute HIV infections, resulted in markedly shortened intervals to VS. Immediate ART provision and active LTC can be key contributors to improved HIV treatment outcomes and the treatment-as-prevention paradigm, with potential for downstream, population-level benefit.
OBJECTIVE: The 'JumpstART' program in New York City (NYC) public Sexual Health Clinics (SHC) provides patients newly diagnosed with HIV with ART (one-month supply) on day of diagnosis and active linkage to HIV care (LTC). We examined viral suppression (VS) among patients who did and did not receive JumpstART services. DESIGN: Retrospective cohort. METHODS: Among newly diagnosed SHC patients (11/23/16-9/30/18) who were matched to the NYC HIV surveillance registry to obtain HIV laboratory test results through 06/30/19, we compared 230 JumpstART and 73 non-JumpstART patients regarding timely LTC (≤30 days), probability of VS (viral load < 200 copies/mL) by three months post-diagnosis, and time to and factors associated with achieving VS within the follow-up period. RESULTS: Of 303 patients, 76% (230/303) were JumpstART and the remaining were non-JumpstART patients; 36 (11%) had acute HIV infections. LTC ≤ 30 days was observed for 63% of JumpstART and 73% of non-JumpstART patients. By 3 months post-diagnosis, 83% of JumpstART versus 45% of non-JumpstART patients achieved VS (log-rank, p < .0001). Median times to VS among virally suppressed JumpstART and non-JumpstART patients were 31 (interquartile range: 24-51) and 95 days (IQR: 52-153), respectively. For groups with and without timely LTC, JumpstART was associated with viral suppression within 3 months post-diagnosis, after adjusting for age and baseline viral load. CONCLUSIONS: Prompt ART initiation among SHC patients, some with acute HIV infections, resulted in markedly shortened intervals to VS. Immediate ART provision and active LTC can be key contributors to improved HIV treatment outcomes and the treatment-as-prevention paradigm, with potential for downstream, population-level benefit.
Authors: Austin M Williams; Kelly Jamison; Samuel T Eppink; Preeti Pathela; Susan Blank; Dana Peters; Thomas L Gift; Andrés A Berruti Journal: Sex Transm Dis Date: 2022-08-11 Impact factor: 3.868