{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T07:59:44Z","timestamp":1785311984014,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,9]],"date-time":"2025-02-09T00:00:00Z","timestamp":1739059200000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010877","name":"ViiV Healthcare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010877","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Differentiated service delivery (DSD) models have been widely implemented for patients in stable HIV care. However, DSD has rarely been offered to newly diagnosed patients. We assessed the effectiveness of early fast\u2010track care during a period of severe civil unrest in Port\u2010au\u2010Prince, Haiti.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a pilot randomized trial among adults presenting with early HIV disease to determine whether early fast\u2010track care (8\u221212 weeks after same\u2010day HIV testing and antiretroviral therapy [ART] initiation) was associated with superior outcomes compared with standard (deferred eligibility for fast\u2010track care). All participants received tenofovir\/lamivudine\/dolutegravir (TLD), and HIV\u20101 RNA &lt;200 copies\/ml was required prior to initiating fast\u2010track care. The primary outcome was 48\u2010week HIV\u20101 RNA &lt;200 copies\/ml, with intention\u2010to\u2010treat analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From December 2020 to August 2022, 245 participants were randomized to standard (\n                      <jats:italic>n<\/jats:italic>\n                      = 116) and early fast\u2010track (\n                      <jats:italic>n<\/jats:italic>\n                      = 129) groups. All initiated TLD on the day of HIV diagnosis. In the early fast\u2010track group, one (0.8%) died, 12 (9.3%) were internally displaced\/emigrated, five (3.9%) were lost\u2010to\u2010follow\u2010up (LTFU), two (1.6%) had a gap in care\/later return, one (0.8%) was transferred and 108 (83.7%) were retained; 88 (68.2%) received 48\u2010week viral load testing and 80 (90.9% of tested; 62.0% of randomized) had HIV\u20101 RNA &lt;200 copies\/ml. In the standard group, two (1.7%) died, six (5.2%) were internally displaced\/emigrated, three (2.6%) were LTFU, one (0.9%) had a gap in care\/later return, one (0.9%) was transferred and 103 (88.8%) were retained; 78 (67.2%) received 48\u2010week viral load testing and 66 (84.6% of tested; 56.9% of randomized) had HIV\u20101 RNA &lt;200 copies\/ml. By design, the sample size of this pilot study was too small to provide definitive evidence of treatment effect, but the primary outcome was numerically higher in the early fast\u2010track group (62.0% vs. 56.9%; RD: 0.051: 95% CI: \u22120.072, 0.174).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early fast\u2010track care was associated with high levels of viral suppression among adults initiating same\u2010day TLD, despite severe civil unrest in Haiti. Completion of 48\u2010week viral load testing was suboptimal, due to the need for participants to leave Port\u2010au\u2010Prince during peak periods of gang\u2010related violence, and the lack of availability of viral load testing for those receiving non\u2010facility\u2010based ART.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.26419","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T19:08:59Z","timestamp":1739214539000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Early initiation of fast\u2010track care for persons living with HIV initiating dolutegravir\u2010based regimens during a period of severe civil unrest in Port\u2010au\u2010Prince, Haiti: a pilot randomized trial"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1428-5015","authenticated-orcid":false,"given":"Jean 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Droit","family":"Dumont","sequence":"additional","affiliation":[{"name":"Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)  Port\u2010au\u2010Prince Haiti"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose Cardelle B.","family":"Riche","sequence":"additional","affiliation":[{"name":"Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)  Port\u2010au\u2010Prince Haiti"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean William","family":"Pape","sequence":"additional","affiliation":[{"name":"Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)  Port\u2010au\u2010Prince Haiti"},{"name":"Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7464-275X","authenticated-orcid":false,"given":"Serena 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