PMID- 34713623 OWN - NLM STAT- MEDLINE DCOM- 20211101 LR - 20211105 IS - 1758-2652 (Electronic) IS - 1758-2652 (Linking) VI - 24 Suppl 6 IP - Suppl 6 DP - 2021 Oct TI - Evaluation of the integration of telehealth into the same-day antiretroviral therapy initiation service in Bangkok, Thailand in response to COVID-19: a mixed-method analysis of real-world data. PG - e25816 LID - 10.1002/jia2.25816 [doi] LID - e25816 AB - INTRODUCTION: Same-day antiretroviral therapy (SDART) initiation has been implemented at the Thai Red Cross Anonymous Clinic (TRCAC) in Bangkok, Thailand, since 2017. HIV-positive, antiretroviral therapy (ART)-naive clients who are willing and clinically eligible start ART on the day of HIV diagnosis. In response to the first wave of the coronavirus disease 2019 (COVID-19) outbreak in March 2020, telehealth follow-up was established to comply with COVID-19 preventive measures and allow service continuation. Here, we evaluate its implementation. METHODS: Pre-COVID-19 (until February 2020) clients who initiated SDART received a 2-week ART supply and returned to the clinic for evaluation before being referred to long-term ART maintenance facilities. If no adverse events (AEs) occurred, another 8-week ART supply was provided while referral was arranged. During the first wave of COVID-19 (March-May 2020), clients received a 4-week ART supply and the option of conducting follow-up consultation and physical examination via video call. Clients with severe AEs were required to return to TRCAC; those without received another 6-week ART supply by courier to bridge transition to long-term facilities. This adaptation continued post-first wave (May-August 2020). Routine service data were analysed using data from March to August 2019 for the pre-COVID-19 period. Interviews and thematic analysis were conducted to understand experiences of clients and providers, and gain feedback for service improvement. RESULTS: Of 922, 183 and 321 eligible clients from the three periods, SDART reach [89.9%, 96.2% and 92.2% (p = 0.018)] and ART initiation rates [88.1%, 90.9% and 94.9% (p<0.001)] were high. ART uptake, time to ART initiation and rates of follow-up completion improved over time. After the integration, 35.3% received the telehealth follow-up. The rates of successful referral to a long-term facility (91.8% vs. 95.3%, p = 0.535) and retention in care at months 3 (97.5% vs. 98.0%, p = 0.963) and 6 (94.1% vs. 98.4%, p = 0.148) were comparable for those receiving in-person and telehealth follow-up. Six clients and nine providers were interviewed; six themes on service experience and feedback were identified. CONCLUSIONS: Telehealth follow-up with ART delivery for SDART clients is a feasible option to differentiate ART initiation services at TRCAC, which led to its incorporation into routine service. CI - (c) 2021 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society. FAU - Amatavete, Sorawit AU - Amatavete S AUID- ORCID: 0000-0002-1902-4016 AD - Institute of HIV Research and Innovation, Bangkok, Thailand. FAU - Lujintanon, Sita AU - Lujintanon S AUID- ORCID: 0000-0001-5380-2013 AD - Institute of HIV Research and Innovation, Bangkok, Thailand. FAU - Teeratakulpisarn, Nipat AU - Teeratakulpisarn N AD - Institute of HIV Research and Innovation, Bangkok, Thailand. FAU - Thitipatarakorn, Supanat AU - Thitipatarakorn S AUID- ORCID: 0000-0003-3639-549X AD - Institute of HIV Research and Innovation, Bangkok, Thailand. FAU - Seekaew, Pich AU - Seekaew P AUID- ORCID: 0000-0002-3941-3457 AD - Institute of HIV Research and Innovation, Bangkok, Thailand. AD - Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA. FAU - Hanaree, Chonticha AU - Hanaree C AD - Institute of HIV Research and Innovation, Bangkok, Thailand. FAU - Sripanjakun, Jirayuth AU - Sripanjakun J AD - Institute of HIV Research and Innovation, Bangkok, Thailand. FAU - Prabjuntuek, Chotika AU - Prabjuntuek C AD - Institute of HIV Research and Innovation, Bangkok, Thailand. FAU - Suwannarat, Lertkwan AU - Suwannarat L AD - Institute of HIV Research and Innovation, Bangkok, Thailand. FAU - Phattanathawornkool, Thana AU - Phattanathawornkool T AD - Institute of HIV Research and Innovation, Bangkok, Thailand. FAU - Photisan, Nuttawoot AU - Photisan N AD - Institute of HIV Research and Innovation, Bangkok, Thailand. FAU - Suriwong, Sujittra AU - Suriwong S AD - Institute of HIV Research and Innovation, Bangkok, Thailand. FAU - Avery, Matthew AU - Avery M AD - FHI 360 and LINKAGES, Bangkok, Thailand. FAU - Mills, Stephen AU - Mills S AUID- ORCID: 0000-0001-7326-6342 AD - FHI 360 and LINKAGES, Bangkok, Thailand. FAU - Phanuphak, Praphan AU - Phanuphak P AD - Institute of HIV Research and Innovation, Bangkok, Thailand. FAU - Phanuphak, Nittaya AU - Phanuphak N AUID- ORCID: 0000-0002-0036-3165 AD - Institute of HIV Research and Innovation, Bangkok, Thailand. FAU - Ramautarsing, Reshmie A AU - Ramautarsing RA AUID- ORCID: 0000-0002-6293-9422 AD - Institute of HIV Research and Innovation, Bangkok, Thailand. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, Non-P.H.S. PL - Switzerland TA - J Int AIDS Soc JT - Journal of the International AIDS Society JID - 101478566 RN - 0 (Anti-HIV Agents) SB - IM MH - *Anti-HIV Agents/therapeutic use MH - *COVID-19 MH - *HIV Infections/diagnosis/drug therapy MH - Humans MH - SARS-CoV-2 MH - *Telemedicine MH - Thailand PMC - PMC8554221 OTO - NOTNLM OT - Asia OT - HIV OT - differentiated care OT - linkage to care COVID-19 OT - same-day antiretroviral therapy OT - telehealth COIS- All authors declare no competing interests related to this work. EDAT- 2021/10/30 06:00 MHDA- 2021/11/03 06:00 PMCR- 2021/10/28 CRDT- 2021/10/29 06:53 PHST- 2021/03/22 00:00 [received] PHST- 2021/08/19 00:00 [accepted] PHST- 2021/10/29 06:53 [entrez] PHST- 2021/10/30 06:00 [pubmed] PHST- 2021/11/03 06:00 [medline] PHST- 2021/10/28 00:00 [pmc-release] AID - JIA225816 [pii] AID - 10.1002/jia2.25816 [doi] PST - ppublish SO - J Int AIDS Soc. 2021 Oct;24 Suppl 6(Suppl 6):e25816. doi: 10.1002/jia2.25816.