The Cooperative Re-Engagement Controlled Trial (CoRECT): Durable Viral Suppression Assessment.

Autor:	O'Shea J; Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Fanfair RN; Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Williams T; DLH Corporation, Atlanta, GA., Khalil G; Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Brady KA; Philadelphia Department of Public Health, Philadelphia, PA., DeMaria A Jr; Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA., Villanueva M; Yale University School of Medicine, New Haven, CT; and., Randall LM; Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA., Jenkins H; Connecticut Department of Public Health, Hartford, CT., Altice FL; Yale University School of Medicine, New Haven, CT; and., Camp N; Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Lucas C; Philadelphia Department of Public Health, Philadelphia, PA., Buchelli M; Connecticut Department of Public Health, Hartford, CT., Samandari T; Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Weidle PJ; Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2023 Jun 01; Vol. 93 (2), pp. 134-142.
DOI:	10.1097/QAI.0000000000003178
Abstrakt:	Background: A collaborative, data-to-care strategy to identify persons with HIV (PWH) newly out-of-care, combined with an active public health intervention, significantly increases the proportion of PWH re-engaged in HIV care. We assessed this strategy's impact on durable viral suppression (DVS). Methods: A multisite, prospective randomized controlled trial for out-of-care individuals using a data-to-care strategy and comparing public health field services to locate, contact, and facilitate access to care versus the standard of care. DVS was defined as the last viral load, the viral load at least 3 months before, and any viral load between the 2 were all <200 copies/mL during the 18-month postrandomization. Alternative definitions of DVS were also analyzed. Results: Between August 1, 2016-July 31, 2018, 1893 participants were randomized from Connecticut (n = 654), Massachusetts (n = 630), and Philadelphia (n = 609). Rates of achieving DVS were similar in the intervention and standard-of-care arms in all jurisdictions (all sites: 43.4% vs 42.4%, P = 0.67; Connecticut: 46.7% vs 45.0%, P = 0.67; Massachusetts: 40.7 vs 44.4%, P = 0.35; Philadelphia: 42.4% vs 37.3%, P = 0.20). There was no association between DVS and the intervention (RR: 1.01, CI: 0.91-1.12; P = 0.85) adjusting for site, age categories, race/ethnicity, birth sex, CD4 categories, and exposure categories. Conclusion: A collaborative, data-to-care strategy, and active public health intervention did not increase the proportion of PWH achieving DVS, suggesting additional support to promote retention in care and antiretroviral adherence may be needed. Initial linkage and engagement services, through data-to-care or other means, are likely necessary but insufficient for achieving DVS for all PWH. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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