SPRINT: Survey of procedures and resources for initiating treatment of HIV in Africa

In its 2017 revision of the global guidelines for HIV care and treatment, the World Health Organization called for rapid or same-day initiation of antiretroviral treatment (ART) for eligible patients testing positive for HIV. Many countries in sub-Saharan Africa have recently adopted guidelines that allow patients who are considered clinically and personally ready to start treatment on the day they are diagnosed, or at any single clinic visit after that. In the years that followed, however, most countries provided little detailed guidance on exactly how to manage treatment initiation, now that multiple preparatory visits are not required. As a result, same-day initiation, and accelerated initiation in general, are being interpreted and implemented on an ad hoc basis, as each facility manager, local jurisdiction, or nongovernmental partner prefers.

The SPRINT (Survey of Procedures and Resources for Initiating Treatment of HIV in Africa) study described the current state of ART initiation in Malawi, Zambia, and South Africa. It combined a facility-level description of the standard of care with a retrospective record review of patients who recently initiated ART at a small sample of healthcare facilities (approximately 12 per country). The survey elicited detailed information about current procedures through structured interviews with clinic staff. The record review for a retrospective cohort of patients eligible for ART estimated actual numbers of clinic visits, services provided, and duration of the steps for treatment initiation from start to finish.

Publications and documents

Huber A, Hirasen K, Phiri B, Tchereni T, Brennan AT, Rosen S. Uptake of same-day HIV treatment initiation in Malawi, South Africa, and Zambia: the SPRINT retrospective cohort. Gates Open Research 2023; 7:42.