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What is meant by "test-and-treat" and what are its individual and public health benefits?

What is meant by "test-and-treat" and what are its individual and public health benefits?

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TEST AND TREAT ARE USED TO ELIMINATE HIV TRANSMISSION AND REDUCE HIV-RELATED DEATHS;

Test and Treat (T&T) is one of the four key components. It is a clinical program providing immediate linkage to HIV care and initiation of ART (antiretroviral therapy) at the time of HIV diagnosis and/or at the time of returning to care after a gap in services. The program benefits the patient’s health and the community by providing initial ART while working through the issues of eligibility and linkage to ongoing HIV care.

RATIONALE FOR TEST AND TREAT PROGRAM FOR ART INITIATION

The HIV Department of Health and Human Services (DHHS) Guidelines currently recommend universal ART for all people living with HIV regardless of CD4 count as soon as possible. Increasing data show a medical benefit to the patient when immediate ART is initiated, particularly during acute/early HIV infection. There is also a community-level public health benefit of reduced HIV transmission. Many patients report that the decision to start ART and the rapid achievement of viral suppression provides them with the first experience of empowerment to live successfully with HIV.

Day 1

(or within 2-3 days)

• New HIV+

• diagnosis or

• chronic HIV infection including returning to care

• Clinician visit to assess/start ART

Day 1

(or within 2-3 days)

• Medical/psychosocial evaluation

• Eligibility assessment

• Obtain baseline labs before or same day ART started

• Counselling

• Linkage to HIV primary care

Day 5-10

Follow Up

Follow up with HIV primary care

• Review baseline Labs

• Call/check on patient (recommend at 2-3 days post-ART start)

• Adjust ART as needed/indicated

Linkage to Care

• Monitor/assure compliance with follow up lab and appointments

Transition to long-term primary HIV Care

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