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P312 Evaluation of an antiretroviral therapy (ART) interruption alert and referral system in british columbia (BC), canada
  1. Jon Kremer,
  2. Rolando Barrios,
  3. David Moore,
  4. Kate Salters,
  5. Katherine Lepik,
  6. Lu Wang,
  7. Karen Slakov,
  8. Jenny Li
  1. BC Centre for Excellence in HIV/AIDS, Vancouver, Canada


Background In mid-2016, the BC HIV Drug Treatment Program (DTP) expanded its province-wide prescriber alert system for ART interruptions to include direct referrals to public health offices for persons off treatment for >4 months. We examined outcomes before and after launch of this Re-Engagement and Engagement in Treatment for Antiretroviral Interrupted and Naïve populations (RETAIN) Initiative.

Methods We analyzed adult, DTP participants with ART interruptions triggering a physician-directed alert (ART refill >2 months late) in pre-RETAIN (Jul-2013 to Apr-2016) and post-RETAIN (May-2016 to Oct-2017) periods, based on the first alert issued within the study period. Follow-up continued until Oct-2018, excluding persons who moved or died within 90 days of an alert being sent. We compared the proportion of persons who were linked to care, re-started ART, or achieved viral suppression in the pre- and post-RETAIN periods, and the time to ART re-initiation using a generalized estimating equation model.

Results There were 3219 alerts sent for 1805 patients, 1374 related to first interruptions in the pre-RETAIN period and 431 post-RETAIN. Of these, 135/431 (31%) post-RETAIN cases were referred to public health within 4 months following the first alert. Patients were predominantly male (74%) with a median age of 47 years. We found no statistically significant differences in the proportions of persons who were linked to care (83% vs 83%), re-started ART within 4 months (73% vs 74%), or achieved viral suppression (61% vs 62%) between the two periods. Among persons who re-initiated ART >4 months following the initial alert, the median (Q1-Q3) time to ART restart declined significantly from 9 (6–15) months pre-RETAIN to 8 (6–11) months post-RETAIN (p=0.004), possibly influenced by public health intervention.

Conclusion We observed shorter time to re-initiation after the introduction of referrals for public health support. Similar systems could be considered in other jurisdictions.

Disclosure No significant relationships.

  • program and implementation
  • Canada
  • prevention
  • intervention and treatment

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