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Early initiation of fast-track care for persons living with HIV initiating dolutegravir-based regimens during a period of severe civil unrest in Port-au-Prince, Haiti: a pilot randomized trial

Early Fast-Track Care for HIV Patients in Haiti

Introduction

We studied the impact of starting fast-track care early for people diagnosed with HIV during a time of severe unrest in Port-au-Prince, Haiti. This approach is usually offered to patients already stable in their HIV treatment, but not to those newly diagnosed.

Methods

In our pilot trial, we looked at adults who were newly diagnosed with HIV. We compared the outcomes of those who began fast-track care within 8-12 weeks of their diagnosis to those who followed the standard process. All participants received the same HIV treatment, and we measured the success based on whether their viral load fell below 200 copies/ml after 48 weeks.

Results

From December 2020 to August 2022, 245 adults took part. Of these:

  • Early fast-track group: 129 participants
  • Standard care group: 116 participants

In the fast-track group, 83.7% of participants remained in care, and 62.0% achieved the target viral suppression. In the standard group, 88.8% remained in care, with 56.9% achieving the same suppression level. Although the pilot study was small, early fast-track care showed promising results.

Conclusions

Fast-track care led to high levels of viral suppression in newly diagnosed adults, even amid the challenges of civil unrest. However, fewer participants completed the 48-week testing due to the situation in Port-au-Prince.

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