Good Initial Experience with Rapid ART Start in San Francisco

Interest has surged in evaluating strategies to address delays in the initiation of antiretroviral therapy (ART) by starting treatment rapidly after diagnosis. This analysis describes the experience of a pilot program at a public clinic in San Francisco. Newly diagnosed HIV+ patients with acute or recent infection (<6 months) were referred to a same-day, resource-intensive clinic, which provided social needs assessment, clinician evaluation, immediate lab draw, and provision of ART, including provision of 5-day starter packs of ART (usually dolutegravir and FTC/tenofovir with observed first dose and telephone follow-up). Eligibility was later expanded to include patients with a CD4 count <200 cells/mm³, those with an active opportunistic in…