Although the linkage-to-care intervention Rapid Start—designed to start patients newly diagnosed with HIV immediately on ART and support equity in care—has been shown by prior data to improve linkages and viral suppression in adults, similar outcomes have not been verified among US youth. To do so, creators of the intervention developed a continuum of care for a young adult (aged 18-24) rapid start population and compared this continuum with an adult population. Patients were linked to a federally qualified health center within 72 hours of HIV diagnosis, with the first ART dose directly observed, patients provided with a 30-day dose pack, labs drawn, and patients undergoing expedited insurance enrollment. Among youth participants, 97% achieved viral suppression with a median of 29 days from diagnosis, 84% remained virally suppressed at 12 months, and 97% remained engaged in care. Comparatively, viral suppression with a median of 28 days from diagnosis, viral suppression at 12 months, and remaining engaged in care were achieved by 98%, 93%, and 98% of adults. Differences between the two groups were not significant. “The intervention outcomes demonstrate that starting adults and youth on ART immediately after diagnosis, before labs are obtained, is safe, well-tolerated, and effective,” write the study authors.
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