Rapid antiretroviral therapy initiation is associated with improved early retention in care and accelerates viral suppression among individuals newly diagnosed with HIV.

Successful human immunodeficiency virus (HIV) treatment may depend on early linkage to care to sustain retention. This study evaluated whether rapid initiation of antiretroviral therapy (ART) improves retention in care and accelerates viral suppression among individuals newly diagnosed with HIV at a Ryan White-funded clinic. This prospective cohort study included treatment-naïve adults diagnosed with HIV between 2021 and 2023. Participants were classified into rapid and non-rapid ART groups based on timing of presentation to care from diagnosis. Among 168 participants, short-term retention at 3-4 months was higher in the rapid group (50% vs. 27%; P = 0.006), but retention at one year did not differ (43% vs. 40%; P = 0.74). Rapid ART was not associated with higher odds of viral suppression within one year after adjustment for baseline characteristics; but was associated with a shorter time to viral suppression by 2.5 times (78 days vs 196 days; P < 0.001).