The Effectiveness of Rapid Antiretroviral Therapy Initiation for People Diagnosed with HIV in an ART Clinic
DOI:
https://doi.org/10.14456/dcj.2026.39Keywords:
rapid antiretroviral therapy, clinical outcome, people living with HIVAbstract
The objective of this study was to compare the clinical outcomes of rapid antiretroviral therapy (ART) initiation (within 1-7 days of HIV diagnosis) with non-rapid ART initiation, The samples were 178 newly diagnosed people living with HIV comprising of non-rapid ART 88 participants and rapid ART 90 participants. The participants were recruited from 27 ART clinics at government hospitals in Nakhon Si Thammarat Province, Thailand, between October 2022 and September 2024, with a minimum follow-up of three months. Data were extracted from medical records and analyzed using descriptive statistics, Chi-square tests, and multiple logistic regression. The Rapid ART group started treatment significantly earlier after diagnosis than the non-rapid group (mean 3.46 vs. 31.31 days). After multivariable adjustment, The rapid ART showed a non-significant trend toward fewer opportunistic infections (ORadj=0.13; 95% CI=0.02-1.16) and lower mortality (ORadj=0.42; 95% CI=0.13-1.42). No significant difference was observed in viral suppression between the two groups (ORadj=1.67; 95% CI=0.87-3.20). However, missed appointments were significantly associated with failure to achieve viral suppression (ORadj = 0.28; 95% CI=0.13-0.62). Underlying comorbidities (ORadj=4.56; 95% CI=1.31-15.89) and tuberculosis co-infection (ORadj=5.28; 95% CI=1.36-20.53) were independently associated with mortality. Receiving care at general or regional hospitals (ORadj=2.98; 95% CI=1.26-7.05) and alcohol use (ORadj=3.78; 95% CI=1.29-11.11) were associated with missed appointments. These findings suggest that timely Rapid ART may help reduce the period of immunocompromised vulnerability. However, clinical outcomes were also influenced by comorbidities, facility-level factors, and patient adherence. Strengthening continuity-of-care interventions, particularly patient tracking systems at hospitals and targeted support for patients with alcohol use, alongside prompt ART initiation is therefore recommended.
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