Conference on Retroviruses and Opportunistic Infections (CROI)

Conference on Retroviruses and Opportunistic Infections (CROI)

Source:

Barnabas R, et al. Abstract 111. Presented at: Conference on Retroviruses and Opportunistic Infections; March 6-10, 2021 (virtual meeting).

Disclosures: Barnabas reports receiving support from Regeneron Pharmaceuticals.
March 08, 2021
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ART home delivery significantly improves viral suppression

Source:

Barnabas R, et al. Abstract 111. Presented at: Conference on Retroviruses and Opportunistic Infections; March 6-10, 2021 (virtual meeting).

Disclosures: Barnabas reports receiving support from Regeneron Pharmaceuticals.
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An ART home delivery program significantly increased viral suppression among patients with HIV in South Africa, according to study results presented at the Conference on Retroviruses and Opportunistic Infections.

“Simplifying ART delivery and monitoring can increase viral suppression,” Ruanne Barnabas, MBChB, DPhil, associate professor of global health and allergy and infectious diseases at the University of Washington, told Healio.

ART delivery fee graphic
Source: Barnabas R, et al. Abstract 111. Presented at: Conference on Retroviruses and Opportunistic Infections; March 6-10, 2021 (virtual meeting).

Barnabas and colleagues recruited 162 patients with HIV who were on ART or willing to initiate ART from Pietermaritzburg, South Africa, and randomly selected 82 to receive ART via home delivery for a fee. The remaining 80 participants received standard, clinic-based ART. The fee for home delivery was tiered based on the income of participants, and the study’s main outcomes were payment of the home delivery fee, acceptability of the delivery service and viral suppression.

The researchers worked with a routing scientist at Amazon to develop a routing algorithm to determine efficient delivery routes and prioritize patients who had a low supply of ART. The study was conducted from October 2019 to December 2021.

Ruanne Barnabas

Of the participants, 62% (101) were on ART and 60% (98) were unemployed. Compared with standard care, home delivery increased viral suppression from 74% to 88% (RR = 1.21; 95% CI, 1.02-1.42). Among men, viral suppression increased from 64% to 84% (RR=1.31; 95% CI, 1.01-1.71). Viral suppression in South Africa is 64% among people living with HIV who receive standard clinical care.

COVID-19 restrictions did not affect patient retention, and the retention rate for all patients was 96%, according to the researchers. Among the patients who received home delivery ART, 98% paid the full fee and 100% reported a willingness to continue to pay the fee.

Barnabas said the study’s main limitation was its small sample size.

“The next step is to repeat this intervention at a larger scale,” Barnabas said.