Plesons Marina, Yang William, Sansbury Griffin M, Suarez Edward, Collington Chevel, Ekowo Elisha, Ciraldo Katrina, Chueng Teresa, Serota David P, Forrest David W, Bartholomew Tyler S, Tookes Hansel E
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
Ann Med. 2025 Dec;57(1):2461670. doi: 10.1080/07853890.2025.2461670. Epub 2025 Feb 10.
People who inject drugs (PWID) living with HIV are less likely to receive care at early disease stages and have low rates of viral suppression. This study examined the feasibility and acceptability of rapid antiretroviral therapy (ART) initiation among PWID with HIV at a syringe services program (SSP) and assessed retention in care after transition to a traditional HIV clinic.
PATIENTS/MATERIALS AND METHODS: A mixed-methods single-arm pilot study was conducted at an SSP in Miami, Florida. Participants with HIV viral load >200 copies/mL were immediately connected with an HIV care provider and received HIV care and peer navigation at the SSP for 6 months, then were transitioned to a traditional HIV clinic. Demographic data were abstracted from the SSP's administrative records. Laboratory assessments and qualitative interviews were conducted at 1, 3, 6, 9, and 12 months.
Sixty-nine percent, 70%, and 69% of participants were virally suppressed (<200 copies/mL) at 1, 3, and 6 months, respectively. Following transition to a traditional HIV clinic, viral suppression remained high at 74% and 79% at 9 and 12 months, respectively. Themes were identified on: 1) barriers to care in traditional HIV clinics, 2) the SSP as a 'safe haven', 3) benefits of the rapid ART initiation program, 4) acceptability of telehealth, and 5) persistent barriers to engaging in HIV care.
Rapid ART initiation for PWID at an SSP was acceptable and feasible and showed preliminary effectiveness in achieving HIV viral suppression and sustaining it after transition to a traditional HIV clinic.
感染艾滋病毒的注射吸毒者（PWID）在疾病早期接受治疗的可能性较小，病毒抑制率较低。本研究调查了在注射器服务项目（SSP）中，为感染艾滋病毒的PWID快速启动抗逆转录病毒疗法（ART）的可行性和可接受性，并评估了转至传统艾滋病毒诊所后的治疗留存率。
患者/材料与方法：在佛罗里达州迈阿密的一个SSP开展了一项混合方法单臂试点研究。艾滋病毒载量>200拷贝/毫升的参与者立即与一名艾滋病毒护理提供者取得联系，并在SSP接受艾滋病毒护理和同伴导航6个月，然后转至传统艾滋病毒诊所。人口统计学数据从SSP的行政记录中提取。在第1、3、6、9和12个月进行实验室评估和定性访谈。
分别有69%、70%和69%的参与者在第1、3和6个月时实现了病毒抑制（<200拷贝/毫升）。转至传统艾滋病毒诊所后，病毒抑制率在第9个月和第12个月分别保持在较高水平，为74%和79%。确定了以下主题：1）传统艾滋病毒诊所的护理障碍；2）SSP作为“安全港”；3）快速启动抗逆转录病毒疗法项目的益处；4）远程医疗的可接受性；5）参与艾滋病毒护理的持续障碍。
在SSP为PWID快速启动抗逆转录病毒疗法是可接受且可行的，在实现艾滋病毒病毒抑制以及转至传统艾滋病毒诊所后维持病毒抑制方面显示出初步效果。
