BACKGROUND: Ongoing HIV medical care is vital in achieving and maintaining viral suppression. We examined viral suppression applying retention in care definitions used by various federal agencies. METHODS: Using National HIV Surveillance System data from 19 US jurisdictions with complete CD4 and viral load reporting, we determined viral suppression among persons who met the National HIV/AIDS Strategy retention in care definition (≥2 visits ≥3 months apart; "retained in continuous care") and among those who had evidence of care but did not meet the definition ("engaged in care"). We also examined viral suppression among persons who met the Health and Human Services Core Indicator definition for retention. RESULTS: Of 338,959 persons living with diagnosed HIV infection in 19 areas in 2010, 63.7% received any care; of these, 19.7% were "engaged in care" and 80.3% were "retained in continuous care." Of those "engaged in care," 47.7% achieved viral suppression compared with 73.6% of persons "retained in continuous care." Significant differences were evident for all subpopulations within each care category; younger persons and blacks/African Americans had lower levels of viral suppression than their counterparts. Persons "engaged in care," regardless of sex, age, race/ethnicity, and transmission category, had significantly lower percentages of viral suppression than persons "retained in continuous care." Similar patterns of viral suppression were found for persons meeting the Health and Human Services definition compared with persons "retained in continuous care." CONCLUSIONS: Higher levels of engagement in care, including more frequent monitoring of CD4 and viral load, were associated with viral suppression.
BACKGROUND: Ongoing HIV medical care is vital in achieving and maintaining viral suppression. We examined viral suppression applying retention in care definitions used by various federal agencies. METHODS: Using National HIV Surveillance System data from 19 US jurisdictions with complete CD4 and viral load reporting, we determined viral suppression among persons who met the National HIV/AIDS Strategy retention in care definition (≥2 visits ≥3 months apart; "retained in continuous care") and among those who had evidence of care but did not meet the definition ("engaged in care"). We also examined viral suppression among persons who met the Health and Human Services Core Indicator definition for retention. RESULTS: Of 338,959 persons living with diagnosed HIV infection in 19 areas in 2010, 63.7% received any care; of these, 19.7% were "engaged in care" and 80.3% were "retained in continuous care." Of those "engaged in care," 47.7% achieved viral suppression compared with 73.6% of persons "retained in continuous care." Significant differences were evident for all subpopulations within each care category; younger persons and blacks/African Americans had lower levels of viral suppression than their counterparts. Persons "engaged in care," regardless of sex, age, race/ethnicity, and transmission category, had significantly lower percentages of viral suppression than persons "retained in continuous care." Similar patterns of viral suppression were found for persons meeting the Health and Human Services definition compared with persons "retained in continuous care." CONCLUSIONS: Higher levels of engagement in care, including more frequent monitoring of CD4 and viral load, were associated with viral suppression.
Authors: Hana Lee; Xiaotian K Wu; Becky L Genberg; Michael J Mugavero; Stephen R Cole; Bryan Lau; Joseph W Hogan Journal: AIDS Date: 2018-09-24 Impact factor: 4.177
Authors: Matthew J Mimiaga; D August Oddleifson; Stephen C Meersman; Annie Silvia; Jaclyn M W Hughto; Stewart Landers; Emily Brown; Paul Loberti Journal: AIDS Behav Date: 2020-04
Authors: Amy R Baugher; Linda Beer; Jennifer L Fagan; Christine L Mattson; Mark Freedman; Jacek Skarbinski; R Luke Shouse Journal: AIDS Behav Date: 2017-09
Authors: E J Edelman; J P Tate; D A Fiellin; S T Brown; K Bryant; N Gandhi; C L Gibert; M B Goetz; K S Gordon; M C Rodriguez-Barradas; R S Braithwaite; D Rimland; A C Justice Journal: HIV Med Date: 2015-02-17 Impact factor: 3.180
Authors: Tonia Poteat; David B Hanna; Peter F Rebeiro; Marina Klein; Michael J Silverberg; Joseph J Eron; Michael A Horberg; Mari M Kitahata; W C Mathews; Kristin Mattocks; Angel Mayor; Ashleigh J Rich; Sari Reisner; Jennifer Thorne; Richard D Moore; Yuezhou Jing; Keri N Althoff Journal: Clin Infect Dis Date: 2020-03-03 Impact factor: 9.079
Authors: Emily C Williams; Judith A Hahn; Richard Saitz; Kendall Bryant; Marlene C Lira; Jeffrey H Samet Journal: Alcohol Clin Exp Res Date: 2016-09-22 Impact factor: 3.455
Authors: Catherine R Lesko; Lynne A Sampson; William C Miller; Jacquelyn Clymore; Peter A Leone; Heidi Swygard; Kimberly A Powers Journal: J Acquir Immune Defic Syndr Date: 2015-12-15 Impact factor: 3.731