IMPLEMENTATION OF THE RAPID CARE MODEL IN A NORTH CAROLINA PUBLIC HEALTH SETTING

Abstract

North Carolina (NC) has a prevalence of approximately 36,700 people living with Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS). In 2016, there was an incidence rate of approximately 1,399 adults and adolescents who were newly diagnosed with HIV/AIDS. NC’s HIV viral suppression rate was at 65%, well below the Joint United Nations Programme on HIV/AIDS (UNDAIDS) goal of 90% suppression. The purpose of this project was to implement the University of California –San Francisco (UCSF) Rapid ART (Antiretroviral Therapy) Program Initiative for HIV Diagnoses (RAPID) model in a resource limited North Carolina public health setting. The UCSF RAPID care model implementation seeks to condense multiple steps for engagement in to care in to one visit resulting in same day linkage to care and initiation of ART, a process shown to improve retention in care and decrease time to viral suppression. Clinic staff included: NP (n=5), PA (n=1), MD (n=1), RN (n=2), MSW (n=2). Referrals came from STI clinics and outside referrals. Medication was obtained from starter/sample packs, patient assistance programs, HIV Medication Assistance Program (HMAP). Median days from diagnosis to first clinic visit was 17 and 86% of patients started ART at first clinic visit. RAPID implementation results shorter time from diagnosis to first clinic visit, decreasing the time to viral suppression. Implementation is feasible and sustainable.