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Individualizing ART with HIV ASSIST
Individualizing ART With Help from HIV-ASSIST

Released: June 10, 2025

Expiration: June 09, 2026

Sunil Solomon
Sunil Solomon, MBBS, PhD, MPH
Activity Information

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Key Takeaways
  • ART individualization can help improve adherence and patient satisfaction with care, but accounting for a myriad of patient characteristics and preferences can be overwhelming for healthcare professionals.
  • HIV-ASSIST is a tool that can aid healthcare professionals in determining the most appropriate, individualized ART regimen for patients by generating a ranked list of potential ART regimens based on patient characteristics, preferences, and regional factors.

In 2023 approximately 6.7 million people in the Asia Pacific were living with HIV, with almost one quarter of new global HIV infections occurring in this region. The response to the HIV epidemic in Asia has been inconsistent despite the need for prevention and management assistance. HIV affects a disproportionate number of people in key populations in this area, and challenges remain in applying the most effective approaches to HIV prevention and treatment.

Shifting Focus to Person-Centered Care
Modern antiretroviral therapy (ART) regimens are highly effective at suppressing viral replication, making HIV manageable as a chronic health condition. WHO recommends that all people living with HIV are initiated on ART, irrespective of their immune status or symptoms. However, many barriers to treatment still persist in Asia, including fear of stigma and discrimination, access challenges, and financial constraints.

As such, retention in care is a challenge in many regions in Asia, and novel approaches to address this gap are required. A new focus on person-centered care means factoring in individual characteristics to personalize therapy based on patient attributes and preferences. Ultimately the goal is to choose regimens that are the most effective and tolerable for each unique patient, and to maximize ART adherence.

Individualization of Therapy
Therapy individualization can be challenging for many reasons. First, national guidelines vary based on location. Healthcare professionals (HCPs) must consider international guidelines like WHO’s HIV guidelines and country-specific recommendations such as NACO guidelines in India.

Furthermore, choosing initial and secondary ART can be complex. Factors such as comorbidities, concomitant medications, resistance mutations, tolerability, contraindications, and viral load/CD4 count need to be considered. In addition, the availability of ART agents changes based on geographic region and in the public vs private sector. Finally, HIV has an ever-evolving treatment landscape with new drug approvals occurring frequently.

As chairman of YRGCare, a nonprofit organization in India dedicated to fighting HIV/AIDS, I have witnessed firsthand the challenges HCPs face in choosing individualized ART regimens.

How HIV-ASSIST Can Help
HIV-ASSIST is a user-friendly tool that aids HCPs to determine the most appropriate, individualized ART regimen for their patients. It allows the user to enter patient-specific information such as HIV-RNA level, CD4 count, comedications, preferences, and known resistance mutations. In addition, treatment drugs can be excluded if they are unavailable in a specific region or for a specific patient. The tool then draws on multiple sources of evidence such as guideline recommendations and clinical trial data to provide a numerically ranked list of suitable ART regimens. Rationale for using each suggested treatment is provided and can be viewed by clicking on a specific regimen. Educational sheets are also supplied and include detailed explanations of drug interactions and adverse effects. 

The availability of HIV-ASSIST as a mobile app provides HPCs access to individualized ranked lists of suitable ART regimens directly on their personal devices. HCPs can appreciate that the evidence-based ART selection has been validated in multiple studies. Furthermore, the user-friendly interface allows quick, yet detailed assessment of suggested regimens.

HIV-ASSIST represents a straightforward way to provide choices for patients, allowing them to actively participate in their HIV care. Instead of a one-size-fits-all ART regimen, HCPs can discuss multiple options with patients and involve their preferences in choosing the best treatment for them. Moreover, education on both individual drugs and the regimen as a whole can be done in real time with easy access to patient education sheets. [Coder link to module 3 when available]

Individualizing HIV treatment is both necessary and challenging. Guidelines provide necessary structure, but there is nuance in determining the ideal person-centered care. HIV-ASSIST is a tool that can aid HCPs in individualizing ART regimens. Its user-friendly interface and availability as a mobile app allows HCPs to quickly become proficient in its use. Its validation in multiple studies and reliance on guidelines and clinical data give them security to rely on its accuracy. Finally, the weighted scoring with a detailed list of regimens allows HCPs to discuss multiple options with patients and choose the best regimen tailored to that person.

Your Thoughts
Do you currently use HIV-ASSIST in your practice? If so, do you find it helpful? If not, do you plan to, or are you interested in learning more about it? Why or why not? Leave a comment to join the discussion!