Same-Day Antiretroviral Therapy Initiation

Study Overview
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Brief Summary
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Data from a total of 2,500 walk-in or referred individuals who have been confirmed (diagnosed) HIV positive and accessing care and treatment services at the hospitals targeted by this study will be examined. The starting period for this project is estimated to be the last quarter (Q4) of fiscal year 2018.

Detailed Description
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This 24-month observation study will be conducted in 13 hospitals of 5 provinces in Thailand: Chiang Rai, Chiang Mai, Ubon Ratchathani, Chonburi, and Songkhla. The research team of TRCARC will collect and analyze secondary and de-identified data from the hospitals' databases. In each site, clients who agree to receive Same-Day ART service will go through standard of care procedures at each hospital, which include: post-test counseling and psychosocial support, baseline lab test, clinical screening, and physical examination. The drug regimen prescribed for clients will mirror the first line ART regimen in Thailand's national guideline, which is tenofovir (TDF), emtricitabine (FTC), and efavirenz (EFV). Retention of the clients will reflect that of the hospital's protocol, and CD4 and viral load will be tested according to the national guideline.

Official Title
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The Thai Red Cross AIDS Research Centre

Conditions
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HIV Infections

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Thai nationals HIV-positive status Acceptance of Same-Day ART Exclusion Criteria: 1. not Acceptance of Same-Day ART
Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acceptance | Acceptance of Same-Day ART | 5 years | 
| Type of Clients | Type of Clients (newly diagnosed or re-engaged) | 5 years | 
| Number of clients categorized by demographic characteristics | Demographic Characteristics: age (years), gender (sex at birth and gender identity), risk behavior(s), and reason(s) for HIV testing | 5 years | 
| Number of clients with each clinical characteristic | Clinical Characteristics based on Thailand's national guidelines (anti-HIV, creatinine, alanine transaminase, syphilis serology, hepatitis B antigen, hepatitis C antibodies, urinalysis, chest X-ray, CD4 count, CDC stage, comorbidity) | 5 years | 
| Number of clients with each ART drug regimen differ from first line ART regimen | Drug regimen, if different from first line drug (TDF, FTC, EFV) | 5 years | 
| Duration between date of HIV diagnosis and date of ART initiation | Duration between date of HIV diagnosis and date of ART initiation | 5 years | 
| Number of clients with each clinical exclusion criteria | Clinical exclusion criterias : suspected TB, suspected cryptococcal meningitis, suspected serious OIs | 5 years | 
| Duration between date of ART initiation to date of being successfully transferred and date of ART continuation | Duration of linkage to care, if applicable (date of being successfully transferred and date of ART continuation) | 5 years | 
| Retention | Retention (retention in care, discontinued ART, loss to follow-up, death) at month 1, month 3, month 6, and month 12 after ART initiation | 5 years | 
| Viral load count | Viral load count (VL tested, percentage of VL suppressed, and dates of VL suppressed) | 5 years |