MOPE488 - Poster Exhibition
TASP a reality? A perspective on linkage and ART initiation in Cambodia, India and Vietnam
S. Sayana1, A. Babakhani1, E. Cleveland2, H. Nguyen3, P. Reis1, C. Sarath1
1AIDS Healthcare Foundation AHF, Los Angeles, United States, 2University of Pennsylvania, Philadelphia, United States, 3AIDS Healthcare Foundation AHF, Hanoi, Viet Nam
Background: If treatment as prevention (TASP) is to become a reality we must improve global HIV programs to ensure shorter linkage (time from 1st time test to first clinical appointment) and ART initiation times (time from being medically eligible to starting ART). In the USA, linkage is 77% within 3-4 months of diagnosis. Medical charts of patients from Cambodia, India and Vietnam were reviewed to draw a comparison with this standard.
Methods: In each country a random sample of HIV patient charts were reviewed based on the following criteria 1) the patient was still active in care 2) the date of the 1st HIV lab test and 1st clinic appointment was documented 3) the patient was not on ART at the time of clinic enrollments 4) the date of starting ART was clearly documented.
Results: In Cambodia 40/69 patient charts fit the above criteria to determine linkage. The median time was 3 days. 31/69 charts in Cambodia fit the criteria to determine ART initiation time which was a median of 11 days. In India, 25/72 charts reviewed fit the above criteria to determine linkage which was a median of 10 days. 24/72 charts fit criteria for determining ART initiation which was 11 days. In Vietnam, the linkage time could not be determined since all the dates of HIV testing were only of the confirmatory tests and not the initial test. However 15/ 20 charts fit the criteria for determining ART initiation times which was a median of 45 days.
Conclusions: Using quality indicators such as linkage and ART initiation times can identify barriers in HIV programs that must be improved. Cambodia had the best linkage duration likely due to their strong PLWHA model the methods for which can be replicated in other programs.
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