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Related Experiment Video

Updated: Jul 23, 2025

Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
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Lessons learned from U.S. rapid antiretroviral therapy initiation programs.

Rupali K Doshi1,2, Shawnika Hull3, Aaron Broun1

  • 1Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.

International Journal of STD & AIDS
|July 18, 2023
PubMed
Summary

Rapid antiretroviral therapy initiation (R-ART) for HIV treatment faces implementation barriers in the US. Key factors for success include strong scientific evidence, stakeholder buy-in, and patient-centered communication for condensed timelines.

Keywords:
CFIRHIV/AIDSimplementationqualitativetreatment initiation

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Area of Science:

  • Implementation Science
  • Public Health
  • Infectious Disease Management

Background:

  • Rapid antiretroviral therapy initiation (R-ART) is recommended for HIV treatment since 2017.
  • Widespread adoption of R-ART across the US remains limited.

Purpose of the Study:

  • To identify facilitators and barriers to R-ART implementation in US HIV clinics.
  • To understand the experiences of early R-ART implementers.

Main Methods:

  • Qualitative study design utilizing semi-structured interviews.
  • Thematic analysis guided by the Consolidated Framework for Implementation Research (CFIR).
  • Interviews conducted with medical leadership from nine early-adopting US HIV clinics.

Main Results:

  • Strong scientific rationale for R-ART, stakeholder buy-in, and condensed timelines were key themes.
  • CFIR's Evidence Strength and Quality construct influenced implementation.
  • Patient acceptance of condensed timelines improved with patient-centered communication and addressing concurrent needs.

Conclusions:

  • Successful R-ART implementation requires addressing logistical planning for condensed timelines.
  • Strategies must accommodate patients' varied reactions to HIV diagnosis and high medication costs.