RESEARCH ARTICLE
Same-day HIV testing with initiation of antiretroviral therapy versus standard care for persons living with HIV: A randomized unblinded trial Serena P. Koenig1,2*, Nancy Dorvil1, Jessy G. De´vieux3, Bethany L. Hedt-Gauthier4, Cynthia Riviere1, Mikerlyne Faustin1, Kerlyne Lavoile1, Christian Perodin1, Alexandra Apollon1, Limathe Duverger1, Margaret L. McNairy5,6, Kelly A. Hennessey1, Ariadne Souroutzidis7, Pierre-Yves Cremieux7, Patrice Severe1, Jean W. Pape1,5
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OPEN ACCESS Citation: Koenig SP, Dorvil N, De´vieux JG, HedtGauthier BL, Riviere C, Faustin M, et al. (2017) Same-day HIV testing with initiation of antiretroviral therapy versus standard care for persons living with HIV: A randomized unblinded trial. PLoS Med 14(7): e1002357. https://doi.org/ 10.1371/journal.pmed.1002357 Academic Editor: Elvin H. Geng, University of California, San Francisco, UNITED STATES Received: January 24, 2017
1 Haitian Study Group for Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti, 2 Division of Global Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America, 3 AIDS Prevention Program, Florida International University, Miami, Florida, United States of America, 4 Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, Massachusetts, United States of America, 5 Center for Global Health, Department of Medicine, Weill Cornell Medical College, Cornell University, New York, New York, United States of America, 6 Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, Cornell University, New York, New York, United States of America, 7 Analysis Group, Boston, Massachusetts, United States of America *
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Abstract Background Attrition during the period from HIV testing to antiretroviral therapy (ART) initiation is high worldwide. We assessed whether same-day HIV testing and ART initiation improves retention and virologic suppression.
Accepted: June 16, 2017 Published: July 25, 2017 Copyright: © 2017 Koenig et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: We have included the anonymized dataset as a Supporting Information file (S1 Data). Funding: This project was supported by the National Institute of Allergy and Infectious Diseases, grant number R01AI104344. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Methods and findings We conducted an unblinded, randomized trial of standard ART initiation versus same-day HIV testing and ART initiation among eligible adults 18 years old with World Health Organization Stage 1 or 2 disease and CD4 count 500 cells/mm3. The study was conducted among outpatients at the Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic infections (GHESKIO) Clinic in Port-au-Prince, Haiti. Participants were randomly assigned (1:1) to standard ART initiation or same-day HIV testing and ART initiation. The standard group initiated ART 3 weeks after HIV testing, and the same-day group initiated ART on the day of testing. The primary study endpoint was retention in care 12 months after HIV testing with HIV-1 RNA
