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HIV ASSIST in Thailand
My Experience With HIV-ASSIST in Thailand 

Released: June 30, 2025

Expiration: June 29, 2026

Tanyaporn Wansom
Tanyaporn Wansom, MD, PhD
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Key Takeaways
  • I find HIV-ASSIST to be practical and accessible for routine clinical use, streamlining what would normally be an extensive decision-making process.
  • HIV-ASSIST is globally adaptable based on regional drug availability.

I volunteer at the Thai Red Cross AIDS Research Centre, where I provide care for a longitudinal cohort of people living with HIV. Many of them are treatment experienced, including some people who were among the first people to receive antiretroviral therapy (ART) when it was made available in Thailand. So, they may have had exposure to medications like stavudine, nevirapine, indinavir ­­—early medications that are not often used anymore. Many of them may also have archived drug resistance from being treated prior to the development of drugs with high resistance barriers.  

Determining the ideal ART regimen for these treatment-experienced individuals can be challenging, and the same is true for the many people newly diagnosed with HIV whom I encounter at that center, who all have their individual circumstances and preferences. Read on to learn how I use the HIV-ASSIST tool to help me optimize ART for each individual. 

HIV-ASSIST for Treatment-Experienced Individuals
One of the great things about HIV-ASSIST is that it centralizes all the different considerations for a person’s HIV management in one place. The population of people who are living and aging with HIV is growing, so I am seeing more and more people with age-related comorbidities, such as cardiovascular disease or diabetes. 

For example, I recently used HIV-ASSIST for decision-making support for a person living with HIV who had worsening kidney function. This worsening kidney function may occur if an individual has been receiving tenofovir for a long time or has other comorbidities, such as diabetes. 

In addition to presenting with worsening renal function, this person was also recently diagnosed with tuberculosis (TB). So I had to consider what other medications they were receiving for TB and what drug–drug interactions may occur.

These types of situations can be challenging, even if you are an experienced healthcare professional. With HIV-ASSIST, I was able to go to one resource to narrow down the list of potential regimens. For this person, I entered all the TB medications that they would be receiving, their current ART regimen, and their comorbidity of chronic kidney disease. Then, HIV-ASSIST presented me with a list of possible regimens, along with the weighted utility score for each one that denoted its level of suitability.

In addition to the list of suitable regimens, HIV-ASSIST also provides the rationale for each regimen. I have found it very useful to look into the extra information to see more detail regarding dosing considerations for this person’s chronic kidney disease, to view contraindications, and to check what lab values to monitor for in this person.

Integrating HIV-ASSIST Into Daily Clinical Practice
As with any new tool or technology, it can feel intimidating to integrate HIV-ASSIST into daily practice. I am not the most technologically savvy person, and I found the interface very easy to use. It is not difficult to plug in the information, and it is also really fast—no waiting for programs to load. Ultimately, I find that it is much quicker than searching for relevant information through clinical guidelines or the literature myself.

In addition to being a guideline-based tool, HIV-ASSIST is built off resources that many of us currently use, like the Stanford HIV Drug Resistance database or the Liverpool database for drug–drug interactions. With HIV-ASSIST, I do not need to go to any of those websites individually anymore. I can go to this one website, and it synthesizes all the information in a way that is easy to read and use. In all, I would encourage people to try the tool and play around with it.

An International Resource
One thing I really appreciate about HIV ASSIST is how it accounts for regional differences in HIV care.

Although HIV-ASSIST was created in the United States, it can tailor its recommendations based on what drugs are available in your country. It does not cite just the US Department of Health and Human Services or CDC guidelines on HIV, but it applies all known relevant guidelines to each individual case, including those from the International AIDS Society as well as guidelines from Asian countries.

HIV-ASSIST also provides short summaries of important clinical trials that provide evidence for each drug regimen, so you can access those papers if you want to go into more depth.

Ultimately, in addition to providing decision-making support, HIV-ASSIST has been really helpful for me—as a healthcare professional outside the academic setting—to keep up to date on the most recent guideline recommendations and new clinical trial evidence for changes in HIV care.

Your Thoughts
In your experience, what are the biggest challenges in optimizing ART for treatment-experienced individuals, and how might tools like HIV-ASSIST help address these challenges, especially in resource-limited or high-complexity clinical settings? Leave a comment to join the discussion!

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