Data-Driven, Patient-Centred HIV Care Supports Sustained Viral Suppression: A Retrospective Programme Analysis From the Medical Research Foundation of Trinidad and Tobago.

INTRODUCTION

Achieving and sustaining viral suppression among people living with HIV remains central to global HIV control efforts. Despite global 95-95-95 targets and the scale-up of differentiated service delivery (DSD) models, many programmes continue to face structural and system-level barriers to sustained treatment outcomes. Evidence on longitudinal HIV treatment outcomes using routinely collected programme data remains limited in Caribbean settings. This study aimed to describe longitudinal trends in HIV treatment outcomes at the Medical Research Foundation (MRF), a large HIV treatment site in Trinidad and Tobago.

METHODS

A retrospective descriptive analysis was conducted using de-identified electronic medical record (EMR) data for all clients receiving antiretroviral therapy (ART) at MRF. Data were analysed across seven fiscal quarters (FY2024 Q2-FY2025 Q4). The programme delivers differentiated, patient-centred HIV care supported by routine EMR monitoring and quarterly programme performance reviews. Key indicators included ART coverage, viral load (VL) testing coverage, viral suppression (VL <1000 copies/mL) and treatment interruptions.

RESULTS

The ART cohort ranged from 4913 to 5202 clients over the study period. VL testing coverage remained consistently high, ranging from 95% to 98% per quarter. Viral suppression was sustained at 94%-95%, reaching 95% in three quarters (FY2024 Q3, FY2025 Q3 and FY2025 Q4). Treatment interruptions declined by approximately 50% over time, while the number of clients active on ART remained stable with a gradual increase in later quarters.

CONCLUSIONS

This study demonstrates sustained high viral suppression and VL testing coverage within a large HIV treatment programme delivering DSD in Trinidad and Tobago. The reduction in treatment interruptions alongside stable high viral suppression highlights the value of routine programme data for monitoring HIV service delivery in real-world settings. These findings provide implementation-relevant insights for strengthening differentiated HIV care models and contribute to the limited evidence base on longitudinal treatment outcomes in Caribbean programme settings.