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Targeting the third '90': Introducing the viral load champion
Sunpath, H Hatlen, T J Naidu, K K Msimango, P Adams, R N Moosa, M-Y S Marconi, V C Murphy, R A Gandhi, R T Pillay, S
Sunpath, H
Hatlen, T J
Naidu, K K
Msimango, P
Adams, R N
Moosa, M-Y S
Marconi, V C
Murphy, R A
Gandhi, R T
Pillay, S
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Abstract
Objective: To move closer to achieving the third target of the UNAIDS 90-90-90 goals, we prospectively implemented a viral load (VL) champion (VLC) program aimed at enhancing VL monitoring and recognition of treatment failure. Design: Three clinics in eThekwini, Kwa-Zulu Natal (low-, medium- and high-volume, encompassing 9184 patients overall) were each assigned a VLC. We employed a descriptive analysis (chart audit) to compare the pre-intervention period to a 1-year post-intervention period. The number of patients with a VL test performed 6 and 12 months after the intervention was calculated as a proportion of VL tests due at those time points (VL completion rate). Results: The pre-implementation VL completion rate at the three sites was respectively 68% (140/205 patients), 54% (84/155 patients) and 64% (323/504 patients), and the 6-month post-implementation completion rate increased to 83% (995/1194 patients), 90% (793/878 patients) and 99% (3101/3124 patients) (P < 0.0001 for each site). VL completion rates remained significantly higher at 12 months post-implementation, with an average cumulative VL completion rate of >90% across all facilities. Conclusion: We demonstrate a successful, multifaceted, quality-improvement intervention centered on a clinic-level VLC which, taken to scale, has important implications for attaining the third UNAIDS 90-90-90 target.
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Date
2018-12-18
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Igenta Connect
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Keywords
AIDS,HIV,South Africa,clinical champion
Citation
Sunpath H, Hatlen TJ, Naidu KK, Msimango P, Adams RN, Moosa MS, Marconi VC, Murphy RA, Gandhi RT, Pillay S, Siedner M, Naidoo K. Targeting the third '90': introducing the viral load champion. Public Health Action. 2018 Dec 21;8(4):225-231. doi: 10.5588/pha.18.0063. PMID: 30775284; PMCID: PMC6361489.