Point-of-care viral load testing among adolescents and young adults living with HIV in Haiti: a randomized control trial

ABSTRACT

HIV viral load (VL) monitoring can reinforce antiretroviral therapy (ART) adherence. Standard VL testing requires high laboratory capacity and coordination between clinic and laboratory which can delay results. A randomized trial comparing point-of-care (POC) VL testing to standard VL testing among 150 adolescents and young adults, ages 10-24 years, living with HIV in Haiti determined if POC VL testing could return faster results and improve ART adherence and viral suppression. Participants received a POC VL test with same-day result (POC arm) or a standard VL test with result given 1 month later (SOC arm). POC arm participants were more likely to receive a test result within 6 weeks than SOC arm participants (94.7% vs. 80.1%; p1000 copies/ml and low self-reported ART adherence was stronger in the POC arm (OR: 6.57; 95%CI: 2.12-25.21) than the SOC arm (OR: 2.62; 95%CI: 0.97-7.44) suggesting more accurate self-report in the POC arm. POC VL testing was effectively implemented in this low-resource setting with faster results and is a pragmatic intervention that may enable clinicians to identify those with high VL to provide enhanced counseling or regimen changes sooner.

Trial registration: ClinicalTrials.gov identifier: NCT03288246.

KEYWORDS:

• Adolescent
• youth
• HIV
• adherence
• viral suppression
• RCT

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Institute of Allergy and Infectious Diseases: [Grant Number K24 AI098627]; Flora Family Foundation; Fogarty International Center: [Grant Number D43 TW10062]; MAC AIDS Foundation; Camela Basin Family Foundation.