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Same Day-Antiretroviral Therapy (SD-ART) ensures immediate access to lifesaving drugs and reduces loss to follow-up following HIV diagnosis. We report how SD-ART was initiated and scaled among community-based Key Population-Led Health Service (KPLHS) providers in seven provinces in Thailand serving predominantly men who have sex with men (MSM) and transgender (trans) women.
ประเด็นสำคัญ
- During October 2022 – September 2023, 33.4% (n=543/1,625) of clients diagnosed with HIV at KPLHS clinics initiated ART on the day of diagnosis, increasing from 18.3% (n=262/1,435) during October 2021 – September 2022.
- The percentage of HIV-positive clients initiated on SD-ART ranged from 6.5% to 52.0% across provinces.
- KPLHS partners worked with government stakeholders and provincial hospitals to address legal, stakeholder-consensus, and insurance-related obstacles.
- Eleven KPLHS clinics were enabled to initiate and scale up SD-ART.
BACKGROUND
Same Day-Antiretroviral Therapy (SD-ART) ensures immediate access to lifesaving drugs and reduces loss to follow-up following HIV diagnosis. We report how SD-ART was initiated and scaled among community-based Key Population-Led Health Service (KPLHS) providers in seven provinces in Thailand serving predominantly men who have sex with men (MSM) and transgender (trans) women.
DESCRIPTION
KPLHS providers Rainbow Sky Association of Thailand, SWING, MPLUS, and CAREMAT operate 11 clinics in seven provinces of Thailand and have collaborative relationships with provincial government hospitals. In 2022, these KPLHS providers piloted SD-ART per the national guidelines.
LESSON LEARNED
During October 2022 – September 2023, 33.4% (n= 543/1,625) of clients diagnosed with HIV at KPLHS clinics-initiated ART on the day of diagnosis, which was an increase from 18.3% (n=262/1,435) during October 2021 – September 2022. Since providers in each province managed SD-ART in unique environments with different challenges, results varied in terms of the percentage of HIV-positive clients initiated on SD-ART, ranging from 6.5% to 52.0%. Obstacles included legal challenges to keeping antiretrovirals (ARVs) at the community clinics, lack of consensus among provincial stakeholders on the need for SD-ART, and treatment delays caused by time needed to determine the appropriate insurance scheme for clients. KPLHS partners worked with government stakeholders and provincial hospitals to address these obstacles, enabling the 11 KPLHS clinics to initiate and scale up SD-ART.
CONCLUSION
The results show that community-based KPLHS providers can be capacitated to successfully offer SD-ART to newly diagnosed people with HIV from MSM and trans communities, giving them immediate access to ARVs from partner hospitals.
