A study by the Spanish AIDS Study Group (GESIDA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) has demonstrated the feasibility and effectiveness of a diagnostic and treatment strategy for human immunodeficiency virus (HIV) in vulnerable individuals, managing to prevent 97 percent of cases in which the virus can be transmitted.
The study, treatment, and retention strategy was tested in vulnerable individuals with HIV through street teams and a mobile unit, including 101 participants, of whom 86.1 percent were men, with an average age of 34 years, predominantly Hispanic (73.3 percent).
Among the participants, 63 percent did not have a home, 25 percent were homeless, 44 percent had problematic drug use in the last year, 30 percent had never taken antiretroviral treatment (ART), and 70 percent had interrupted it.
Participants started ART, based on a single tablet of BIC/FTC/TAF, on the same day as diagnosis and were followed for 48 weeks, during which they received social support to encourage attendance for monitoring visits and collect treatment at pharmacies.
The retention rate at week 48 was 64.4 percent, with the main reasons for non-attendance being loss (19.8 percent), relocation to another city (5.9 percent), and incarceration (5 percent).
Meanwhile, adherence to ART was incomplete in 57.3 percent of participants, and 10.1 percent interrupted ART for more than 20 days at the time of the medical visit; In the last week analysis, 96.9 percent of patients achieved viral suppression below 50 copies per milliliter.
Of these, two patients interrupted ART at the time of their week 48 visit, and virological failures were not observed during the study; In multivariate analysis, HIV acquisition through injectable drug use was associated with lower retention in HIV care.
Although adverse effects were reported in 68.3 percent of patients, 95.3 percent were of mild intensity and none required treatment discontinuation, which was «widely accepted» with over 95 percent satisfaction reported, including ease of access, support from the healthcare team, and assistance.
The results of the «simplified» clinical study, presented at CROI 2025 in San Francisco (United States), also showed that new HIV care models should emphasize social support to improve the most vulnerable individuals, such as those diagnosed in the context of injected drug use.
