Same-day ART start improves HIV outcomes
Rapid ART initiation raised 90-day treatment start and 10-month viral suppression versus standard multi-visit initiation.
Source
Initiating Antiretroviral Therapy for HIV at a Patient's First Clinic Visit: The RapIT Randomized Controlled Trial
Study at a glance
- Design
- RCT — RapIT: accelerated same-day ART initiation vs usual stepwise initiation at two public clinics
- N
- N=463 · Rapid vs standard arms with 90-day initiation and 10-month suppression analyses on randomised subsets
- Population
- Adults with HIV at two South African public clinics
- Outcome
- ART initiation by 90 days and viral suppression by 10 months
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Same-day ART start improves HIV outcomes
These passages occur verbatim in the stored paper text. They support the points listed below; they do not verify every statement in the explanation.
463 patients were enrolled.
463 provided written informed consent and were enrolled in the study ().
90-day ART initiation was 97% vs 72%.
By 90 d after study enrollment, 97% (182/187) of participants in the rapid arm and 72% (136/190) of participants in the standard arm had initiated ART, equating to a risk difference of 25% (95% CI 19%–33%) and a crude relative risk of 1.36 (1.24–1.49) ().
What they did
RapIT randomised adults at two public clinics to accelerated first-visit ART initiation versus usual stepwise initiation, then compared ART start by 90 days and viral suppression by 10 months.
What they found
Of 463 enrolled, rapid-arm patients initiated ART by 90 days far more often (97% vs 72%) and had higher 10-month suppression (64% vs 51%).
The limits
What it doesn't show
Unblinded service trial in two clinics may not generalise to all settings; suppression was not universal even in the rapid arm.
Key terms
- RapIT
- Rapid Initiation of Treatment randomised service trial.
- ART
- Antiretroviral therapy for HIV.
- Viral suppression
- Plasma HIV RNA reduced below the study threshold.
- Same-day initiation
- Starting ART at or near the first clinic visit.
- Risk difference
- Absolute percentage-point difference between arms.
- Standard care
- Usual multi-visit ART preparation pathway.
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RapIT compared:
Common questions
90-day initiation rapid vs standard?
97% vs 72%.
10-month suppression?
64% vs 51%.
How many enrolled?
463.
Was it randomised?
Yes—unblinded individually randomised.
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