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Doctoral candidate Thinh Vu (far right) and fellow Fogarty-IeDEA Mentorship Program participants (from left) Chatkamol (Bua) Pheerapanyawaranun, Dr. Azar Kariminia, and Dr. Dhanushi Rupasinghe at the Kirby Institute in Sydney where the study research was conducted.
In a study published in AIDS Research and Therapy, PhD candidate Thinh Vu explores the temporal trends in the time from HIV diagnosis to the initiation of antiretroviral therapy (ART) across the Asia-Pacific region. This cohort study, analyzing data from nearly 15,000 adults living with HIV from nine countries/territories between 2013 and 2023, found a substantial decrease in the median time to ART initiation.
The median time from HIV diagnosis to ART initiation decreased from 51 days (2013-2015) to 28 days (2016-2019) and further to 26 days (2020-2023). This improvement aligns with evolving World Health Organization guidelines promoting earlier treatment. Moreover, the COVID-19 pandemic did not appear to impact ART initiation in the region.
Higher country income levels, HIV transmission through male-to-male contact or injection drug use, and later years of HIV diagnosis were associated with shorter time to ART initiation. Conversely, individuals with higher CD4 counts at diagnosis experienced longer treatment times. Despite the progress, the study highlights the crucial need for optimizing treatment initiation during the “treat-all” era, especially among individuals with higher CD4 counts who may experience delays in accessing care.
“Our findings demonstrate the significant strides made in the Asia-Pacific region in ensuring timely access to ART for people living with HIV,” says Thinh Vu. “These improvements are likely a result of the widespread adoption of WHO guidelines recommending immediate treatment upon HIV diagnosis. However, we must continue to address the remaining challenges, particularly in ensuring that individuals with higher CD4 counts, who may feel less urgent about starting treatment, receive the care they need.”
Prior to this publication, Thinh Vu presented the findings at HIV Glasgow 2024, UK. This project is part of his Fogarty-IeDEA Mentorship Program 2024-2025, supported by “Student Success Award” from CUNY SPH Graduate Student Government Association. Through this program, he is being trained to develop skills in study design, data management, analysis, interpretation, and dissemination of research derived from large HIV clinical databases in the Asia-Pacific region.
