Same-Day Antiretroviral Therapy as a Behavioral Design Intervention to Reduce Stigma in Key Affected Populations

The proposed study has 3 aims:

• Conduct asynchronous online focus groups (AOFGs) and flowcharting to map the current ART initiation process and design a streamlined same-day antiretroviral therapy (SD-ART) protocol as a behavioral design.
• Assess the multi-level barriers and facilitators to refine and implement an SD-ART protocol from the perspectives of patients, clinicians, and administrators, considering the high levels of stigma and suboptimal HIV treatment outcomes. Findings from Aims 1 and 2 will guide Aim 3.
• Pilot-test the protocol-concordant SD-ART strategy in newly diagnosed People with HIV where investigators will assess and follow multi-level stigma constructs in patients and providers, analyzed through longitudinal dyadic analyses, to provide the evidence for SD-ART as a behavioral design intervention that reduces stigma.

The focus of this registration is the trial in aim 3.

Inclusion criteria

• Aim 1:

HIV experts will be selected from National Societies of HIV experts according to the following criteria: 1) 18 years old or older; 2) Be an HIV expert, including those from NGOs providing HIV care, and international specialists; 3) Provide informed consent.

• Aim 2:

• NGT Focus Groups (FG)

• Staff members

• 18 years old or older.
• Be a clinical staff member at Hospital Dos de Mayo or Patrucco Primary Health Center.
• Provide informed consent.
• PWH receiving HIV care

• 18 years old or older.
• Identify as member of a KAP.
• Receive HIV care at Hospital Dos de Mayo or Patrucco Primary Health.
• Provide informed consent.
• PWH who dropped out of HIV care

• 18 years old or older.
• Identify as a member of a KAP.
• Previously received HIV care at Hospital Dos de Mayo or Patrucco Primary Health but dropped out of care, as identified through patient registries.
• Provide informed consent.
• In-depth interviews

• 1) 18 years old or older.
• 2) Be the director of Hospital Dos de Mayo or Patrucco primary health center or the HIV director at the Ministry of Health
• 3) Provide informed consent
• Aim 3:

• Clinical Staff Dyadic Surveys

• 1) 18 years old or older.
• 2) Be an HIV provider at Hospital Dos de Mayo or Raul Patrucco Primary Health Center.
• 3) Provide HIV care to one of the 125 PWH
• 4) Provide informed consent.
• Patient Dyadic Surveys

• 1) 18 years old or older.
• 2) Identify as a member of a KAP.
• 3) Be newly diagnosed with HIV and eligible for SD-ART based on clinical criteria identified from Aims 1 and 2.
• 4) Provide informed consent.