Access to (and Continuity of) HIV Care
If you haven't heard the phrase "treatment cascade" yet, now's the time to get on board. The concept is likely to shake out as one of the transformative moments in our understanding of the HIV epidemic in the U.S., while also provides a reminder about how powerful it can be to portray data visually.
Originally published in Clinical Infectious Diseases last March, the treatment cascade casts in stark relief exactly where the largest gaps are that need to be filled when it comes to the process of getting HIV-infected individuals onto successful antiretroviral therapy. The cascade notes that, of the approximately 1.2 million individuals living with HIV in the U.S., 82% have been diagnosed; 66% have been linked to HIV care; just 37% are retained in care; 33% are prescribed antiretroviral therapy; and 25% have an undetectable viral load.
As Michael Horberg, M.D., discussed at CROI; Irene Hall, Ph.D., discussed at the International AIDS Conference; and Greg Millett, M.P.H., discussed at IDWeek 2012, there is a tremendous amount we have yet to learn about the best ways to fill these gaps, and the factors that lead to them being so wide (particularly for harder-hit populations, such as African Americans). But the conversation has begun in earnest, and it raises hopes that we can transform the landscape of HIV care before more individuals fall through the cracks.