Rapid care access improves outcomes in HIV

At a clinic in Miami, patients with newly diagnosed HIV infection who had fast-track referrals to start antiretroviral therapy demonstrated superior outcomes in terms of viral suppression and CD4 count recovery compared with those receiving standard care.

METHODOLOGY:

• Test and Treat/Rapid Access is an HIV care pathway that fast-tracks newly diagnosed patients to medical visits and antiretroviral therapy initiation — often on the same day as diagnosis, rather than waiting weeks under the traditional standard-of-care process — which involves case manager evaluation followed by initial appointment.
• Researchers compared the characteristics of 95 patients with HIV infection entering HIV care through the traditional standard-of-care pathway (n = 64; average age, 45.4 years) vs the rapid access program (n = 31; average age, 37.8 years) at an adult HIV clinic in Miami.
• They reviewed electronic medical records of patients who initiated antiretroviral therapy between March 2016 and March 2018, with follow-up to 6 years following entry into care, and assessed clinical outcomes, including virologic suppression, CD4 recovery, entry to care, and retention in care.

TAKEAWAY:

• Viral load suppression was achieved by 95% of patients in the rapid access group compared with 84% of patients in the standard-of-care group, with median time to suppression of 107 vs 175 days, respectively (P < .0425).
• CD4 count > 200 cells/mm³ was achieved by 96% of patients in the rapid access group with a significantly shorter median time to recovery than those in the standard-of-care group (87 vs 277 days; P = .0006).
• Patients in the standard-of-care group with prior HIV-related hospitalization had significantly longer mean wait times to enter care (123 weeks) than those without hospitalization (62 weeks) and those in the rapid access group (2.5 weeks).
• Long-term retention rates showed no significant differences between rapid access and standard care without hospitalization (71% vs 76%, respectively); however, those with prior HIV-related hospitalization in the standard-of-care group had a lower retention rate of 47% (P = .0302).

IN PRACTICE:

“Developing further evidence on optimal screening, prophylaxis, diagnostics, and treatment strategies for these infections is essential for informing practices and policies that aim to reduce mortality among these patients,” the authors of the study wrote.

SOURCE:

The study was led by Allan E. Rodriguez, of the University of Miami Miller School of Medicine, Division of Infectious Disease in Miami. It was published online on July 17, 2025, in the Journal of Acquired Immune Deficiency Syndrome.

LIMITATIONS:

As this was a retrospective study conducted at a single large medical center, researchers were unable to determine whether patients who were lost to follow-up had died, been transferred to another facility, or left the area.

DISCLOSURES:

Funding information was not provided for this study. The authors reported having no relevant conflicts of interest.