Rapid ART

Rapid ART is the administration of antiretroviral therapy as early as possible after an HIV diagnosis and, ideally, at the same clinic visit as the HIV diagnosis. Rapid ART is the standard of HIV treatment. Clinic processes to adopt rapid ART include development of protocols, staff training, development of teams that can facilitate delivery of rapid ART, and client education. 

Best Practices

  • Rapid ART Dissemination Assistance Provider
    Model Rapid Start projects, with highlights on their key features, video overviews, process maps, and detailed descriptions.
  • Center for Innovation and Engagement
    Collection of implementation guides on evidence-informed best practices in HIV care delivery.
  • Center for Innovation and Engagement
    CrescentCare seeks to start all people with HIV who have been newly diagnosed on antiretroviral therapy (ART) within 72 hours of diagnosis. The intervention provided a 24-hour navigator to coordinate linkage services and streamlined intake.
  • Best Practices Compilation
    The CrescentCare Start Initiative is a program of CrescentCare, a Federally Qualified Health Center, and the New Orleans Office of Health Policy. The initiative connects people with newly diagnosed HIV to antiretroviral therapy (ART) through intensive patient navigation and a streamlined intake process. Time between HIV diagnosis and linkage to HIV medical care has decreased from 30 days to only 1.3 days.   
  • Best Practices Compilation
    The Huntridge Family Clinic launched the Rapid Start Initiative to provide same-day ART treatment and comprehensive case management to clients with a new diagnosis of HIV. Over 90% of clients received ART on the same day as diagnosis, and 78% of clients were retained in care within the first year of starting treatment.
  • Best Practices Compilation
    Kern County Rapid ART links people with a new diagnosis of HIV to ART. The Kern County Health Officer’s Clinic identifies people with a new diagnosis of HIV through onsite testing, surveillance data, and referrals from local hospital emergency departments. Kern County Rapid ART provides support services and refers clients to other community clinics for ongoing care. A study of clients with a new diagnosis of HIV in 2021 found that on average, Kern County Rapid ART clients were linked to care and provided ART within two days of diagnosis.
  • Best Practices Compilation
    POP-UP provides low-barrier comprehensive HIV primary care, substance use services, mental health services, and case management to people who are homeless and unstably housed with the goal of retaining clients in care and improving viral suppression. Among POP-UP participants, 44% who were unstably housed and not virally suppressed at the start of the study were virally suppressed 12 months after enrollment.
  • Best Practices Compilation
    Positive Care Center implemented the Rapid Access program in 2018, providing clients with ART on the same day as HIV diagnosis. Pharmacists, embedded within Positive Care Center’s care team, help clients with their treatment plans and adherence strategies. Over 90% of clients served through Rapid Access in 2021 received ART on the same day as diagnosis, and 82% of clients were retained in care at six months.
  • Best Practices Compilation
    The Virginia Commonwealth University implemented a clinical quality improvement project to increase linkage to HIV medical care within 30 days and initiation of antiretroviral therapy (ART) at the first visit by making “Rapid Access” appointments available each week for people with newly diagnosed HIV.
  • Best Practices Compilation
    Rapid ART Program Initiative for New Diagnoses (RAPID) was designed to connect people with a new HIV diagnosis to ART within five days of diagnosis and within one day of their initial care visit. Linkage navigators counseled people on HIV care, identified an available clinician capable of immediately prescribing ART, scheduled the clinical appointment, and connected people to additional support services. RAPID led to a reduction in median time between initial diagnosis and both ART initiation and viral suppression.
  • Best Practices Compilation
    The Rapid ART Start Protocol focuses on helping veterans with a new HIV diagnosis access ART and comprehensive treatment as soon as possible. A retrospective cohort study showed positive outcomes, including decreases in the time to first appointment, the time to ART initiation, and the time to reach viral suppression. In addition, patients receiving the intervention were more likely to reach viral suppression compared to patients seen pre-intervention at the same clinic.
  • Rapid ART Dissemination Assistance Provider

    These resources designed to support activities to adopt Rapid Start as a standard of care.

  • Best Practices Compilation
    Through the Test & Treat Rapid Access (TTRA) Program, clients with a new HIV diagnosis in Miami-Dade County can access ART, receive other services and counseling, start enrolling in RWHAP, and connect to HIV primary care during the initial visit. At Borinquen Health Care Center, one of the clinical sites participating in TTRA, 76% of clients were virally suppressed within three months of receiving a rapid ART start, and 95% were retained in care for 12 months.
  • Best Practices Compilation
    The Test and Treat initiative, implemented by Oklahoma State University, connects people to antiretroviral therapy (ART) within 14 days of HIV diagnosis through streamlined intake and initial clinic visit protocols and 30-day medication starter packs. Participants in Test and Treat are linked to care and reach viral suppression sooner, and are more likely to be retained in care, as compared with people in standard care.
  • Best Practices Compilation
    The Max Clinic, located within the University of Washington’s Harborview Medical Center complex in Seattle, offers walk-in services and incentives to clients reengaging in HIV care, especially those who have not been well served by the traditional health care model—including clients who are experiencing homelessness, or who have mental health and substance use issues. The Max Clinic offers rapid antiretroviral therapy, incentives, a flexible clinical model, and access to comprehensive support services. Max Clinic clients were significantly more likely to reach viral suppression after 12 months than a comparable control group.

Resources

Webinars

Conference Presentations

HRSA HIV/AIDS Bureau, Division of State HIV/AIDS Programs
2022 National Ryan White Conference on HIV Care & Treatment
William Paterson University
Debbie Mohammed, Sunny Choe, Russell Brewer, Jason Leider
2022 National Ryan White Conference on HIV Care & Treatment
Thomas Street Health Center at Harris Health System
Jennifer Carey
2022 National Ryan White Conference on HIV Care & Treatment
University of Virginia Health System
Kevin Fekete, Adam Archer, Lindsey Buscemi
2022 National Ryan White Conference on HIV Care & Treatment
Tarrant County HIV Administrative Agency
James d'Etienne, Thomas Donohoe, Douglas White, Lisa Muttiah, Afiba Agovi
2022 National Ryan White Conference on HIV Care & Treatment

Technical Assistance

  • TAP-in supports the 47 EHE jurisdictions funded by HRSA to strengthen their EHE work plans, promote cross-jurisdictional learning, and ensure jurisdictions have access to the resources they need. Project period: 2020-2025.

  • The central hub of the AETC Program, the clinical training arm of the RWHAP, through HIV curricula, technical support to regional AETCs on practice transformation and best practices, and housing of all AETC-developed tools for HIV clinical staff. Project period: 2019-2024.
  • The AETC Program offers clinician education and tailored capacity-building assistance. Project period: 2019-2024.
  • Initiative documenting best practice strategies and interventions that have been shown to improve HIV outcomes in a "real world" setting and can be replicated by other programs. Project period: 2021-2024.
  • SPNS initiative on implementation and evaluation of interventions that accelerate initiation of antiretroviral therapy (Rapid Start). Project period: 2020-2024.