Nearly all service members achieve viral suppression in DoD model of care
Nearly all service members — 99% — who received continuous care through the Department of Defense model for HIV care were virally suppressed within 1 year of starting ART, according findings in MMWR.
“The Department of Defense (DoD) periodically evaluates HIV treatment outcomes in active duty service members to improve clinical care and to inform policy,” Lieutenant Colonel Jason F. Okulicz, MD, MC, chief of ID service for Brooke Army Medical Center/San Antonio Military Medical Center and U.S. Air Force ID consultant, told Healio.
In the current study, researchers estimated ART use and rates of viral suppression among DoD service members with HIV infection from January 2012 through June 2018 using data from the Defense Medical Surveillance System (DMSS). Between Jan. 1, 2012 and Dec. 31, 2017, 1,050 service members were newly diagnosed with HIV infection. Most of these individuals (89.4%) received ART within 6 months of HIV diagnosis; 95.4% received it within 12 months and 98.7% received it by the end of the surveillance period on June 30, 2018.
Of the 793 individuals who started ART and continued military service for one year or more, 93.8% received continuous ART. Viral suppression was achieved by 99% of individuals within 1 year of starting ART and by 96.8% of participants at the last viral load test during the surveillance period.
The authors do note several limitations with the study, including the fact that information about ART was obtained through health records; no data related to medication adherence was available. However, the viral load tests done by Okulicz and colleagues following the distribution of ART “suggest a high level of adherence,” according to the report.
Okulicz called viral suppression “the principal goal” of HIV treatment.
“The DoD model of HIV care demonstrates a high uptake of ART and achievement of viral suppression in a large health care system despite high mobility and geographic dispersal of active duty service members,” he concluded. – by Caitlyn Stulpin
Disclosure: Okulicz reports no relevant financial disclosures.