Immediate Initiation of Antiretroviral Treatment (iART) Action Kit - NYC Health

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Immediate Initiation of Antiretroviral Treatment (iART) Action Kit

The recommended standard of HIV care in New York is to initiate antiretroviral treatment (ART) on the day of diagnosis, at the first clinic visit, or on the day a client returns to care. A number of randomized clinical trials found that initiating ART on the day of diagnosis increases the proportion of clients who were virally suppressed and retained in care after 12 months. Immediate treatment allows clients to engage in HIV care without delay and can empower them to disclose their status to partners, friends and family.

The Immediate Initiation of Antiretroviral Treatment (iART) Action Kit includes provider and client resources. It is structured around these core HIV treatment practices:

Offer HIV testing to all clients at least once a year, and more frequently to clients who may benefit from testing every three to six months. Per New York State (NYS) guidelines, providers should offer HIV testing to all clients at least once a year, and more frequently to clients who may benefit from testing every three to six months, such as clients taking PrEP.

Initiate ART as soon as possible, preferably on the same day of diagnosis. Given the robust evidence supporting the individual and population health benefits of immediate ART initiation, NYS HIV guidelines recommend starting ART as soon as possible, preferably on the same day of an HIV diagnosis.

Perform genotype resistance testing on all clients with HIV, but do not wait for genotype testing results to initiate eligible clients on iART. Clinical guidelines from NYS, International AIDS Society, U.S. Department of Health and Human Services, and the World Health Organization recommend performing genotype resistance testing on all clients diagnosed with HIV, but not waiting for genotype testing results to initiate eligible clients on iART.

Establish an iART clinic workflow. Research has shown that successful iART program implementation includes a workflow with a benefits, linkage, and care navigation component.

Provider Resources

HIV Testing Palm Card (PDF)

iART Payment Options (PDF)

Guidance for Genotype Resistance Testing Before iART (PDF)

iART Clinic Workflow (PDF)

NYS/NYC iART Dear Colleague Letter (PDF)

iART Brief Guidance for Medical Providers (PDF)

iART Expectations & Pledge to Become an iART Clinical Partner (PDF)

NYSDOH AI Rapid ART Initiation Pocket Guide (PDF)

U.S. Preventive Service Task Force (USPSTF) Recommendations: HIV Screening and PrEP (PDF)

NYC Health Map Postcard (PDF)

NYSDOH AI: Framework for Sexual History Pocket Guide (PDF)

HIV Surveillance Annual Report, 2021 (PDF)

iART Printable Folders

Client Education Materials

NYC Health Bulletin: Making HIV Undetectable (PDF)

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More information

iART

To schedule an iART public health detailing visit, please contact the HIV Clinical Technical Assistance Team at COTA@health.nyc.gov