(P167) A RAPID INITIATION OF ANTIRETROVIRAL THERAPY PROGRAM AT DENVER SEXUAL HEALTH CLINIC

Background:
Rapid initiation of antiretroviral therapy (ART) has been shown to improve short term linkage to care (LTC) and reduce time to viral suppression in people with human immunodeficiency virus (HIV). In 2019, the Denver Sexual Health Clinic (DSHC) implemented a Fast Anti-Retroviral Start (FAST) program for patients newly diagnosed with HIV. The program prioritized treating individuals experiencing barriers to accessing insurance.

Methods:
FAST services included a medical provider evaluation, LTC to an HIV provider, and a 1-month supply of ART. Outcomes of FAST patients from 9/1/2019 to 12/30/2023 were evaluated. Demographics, risk factors, laboratory values, and visit data were extracted from the DSHC medical record and the Enhanced HIV/AIDS Reporting System. Retention in care was defined as a viral load (VL) obtained >1 year after FAST enrollment.

Results:
FAST was initiated in 119 patients. Patient characteristics were median age 33 years (IQR 28-39); 94.1% men; 26.9% White non-Hispanic, 13.5% Black non-Hispanic, and 55.5% Hispanic; 72.3% uninsured; 42.9% with substance use; 37.8% with incomes below the federal poverty level. Baseline median CD4 cell count was 431 cells/µl (IQR 254-569) and VL was 68,157 copies/ml (IQR 15,626-373,300). The median time from a confirmatory test to a FAST visit was 3 days (IQR 0-6); median time from ART to VL suppression ( <200 copies/ml) was 28 days (IQR 17-55) and ART to VL undetectable ( <30 copies/ml) was 56.5 days (IQR 28-123.5). 116 (97.5%) patients were linked to care; 98/117 (84.5%) had viral suppression within 3 months of FAST start; 88/116 (75.9%) had a VL >1 year after their FAST visit.

Conclusion:
The FAST program achieved high levels of viral suppression and linkage to care in a population predominantly Hispanic, uninsured, with low-income levels. Rapid ART implementation in sexual health clinics is feasible and may present an opportunity to advance Ending the HIV Epidemic goals.