Viral Suppression Following Same-day Initiation Antiretroviral Therapy among Persons Aware of their Classification as...

Area of Science:

• Public Health
• Infectious Diseases
• HIV/AIDS Research

Background:

• Understanding HIV infection recency can influence patient behavior and antiretroviral therapy (ART) outcomes.
• The impact of awareness regarding HIV infection classification (recent vs. long-term) on treatment outcomes requires investigation.

Purpose of the Study:

• To determine if awareness of recent HIV infection classification influences same-day ART initiation and viral load suppression (VLS) at 6 months post-initiation.
• To compare ART outcomes between individuals aware of recent versus long-term HIV infection classification.

Main Methods:

• A cohort study of 1,238 adults newly diagnosed with HIV in Rwanda (August 2021-October 2022).
• Utilized a rapid test for recent infection (RTRI) and viral load (VL) testing at baseline and 6-month follow-up.
• Classified infections as RITA-recent or RITA-long-term based on RTRI results and baseline VL (≥1000 copies/mL).
• Calculated VLS rates and estimated Risk Ratios (RRs) for VLS.

Main Results:

• Nearly all participants (99.6%) initiated same-day ART.
• Follow-up VLS rates were similar between those aware of RITA-recent (94%) and RITA-long-term (94%) classifications.
• Awareness of RITA classification was not significantly associated with 6-month VLS (RR=1.01; 95% CI: 0.96-1.06).

Conclusions:

• In Rwanda, awareness of HIV infection recency classification (RITA) did not affect viral load suppression at 6 months post-ART initiation.
• The majority of newly diagnosed individuals initiated same-day ART and achieved VLS, irrespective of their infection classification.
• Effective ART initiation and VLS can be achieved regardless of HIV infection recency awareness in this setting.