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Michigan Rapid Start ART (MiStart)

Rapid start antiretroviral therapy (ART) is the recommended clinical practice model for providing care by U.S Federal Guidelines for people with new and existing HIV (PWH) diagnoses nation-wide, unless there are contraindications. As stated in the National HIV/AIDS Strategy (NHAS) 2022-2025 goal 2.1.1, providing rapid start equates to starting ART the same day or within 7 days of diagnosis AND includes linkage to HIV health care within 30 days. The Strategy sets bold targets for ending the HIV epidemic in the United States by 2030, including a 75% reduction in new HIV infections by 2025 and a 90% reduction by 2030. An additional component of the Ending the HIV Epidemic (EHE) plan is to rapidly treat PWH to reach sustained viral suppression (Undetectable=Untransmittable or U=U).  

Michigan Rapid Start ART (MiStart) is Michigan’s implementation of rapid start ART. MiStart will result in earlier HIV viral suppression, improved retention in care and reduced HIV transmission. MiStart also improves equity and accessibility of ART for people who may otherwise be lost to follow-up after diagnosis and has proven community level benefits by reduced HIV transmission.