HIV Care Continuum

The HIV Care Continuum describes the proportion of persons living with HIV who are receiving HIV care and who have achieved viral suppression. It is based on reported CD4 count and viral load tests, which are utilized as proxy measures for receipt of HIV care. The HIV care continuum provides a means of monitoring progress toward the achievement of objectives outlined in the National HIV/AIDS Strategy for the United States (NHAS), released by the White House in July 2010, and updated in 2015. The Care Continuum captures several stages in the care of people living with HIV:

HIV diagnosis: It is estimated that approximately 15% of people living with HIV in the nation didn’t know they had it as of 2014. The proportion of persons living with HIV in Georgia with undiagnosed HIV is estimated at 15%. The only way to know for sure if one is infected with HIV is to be tested. Undiagnosed persons run the risk of disease progression, and transmitting the virus to others.

Linkage to care: Timely entry into medical care is important for treatment of HIV and other medical conditions. Since 2015, linkage to care is measured as the percent of people who are seen for HIV care within 1 months of diagnosis.

Any care: Any care is a measure of minimal commitment to continued care with at least 1 HIV care visit in a year.

Retained in care: Retention in care more closely reflects the recommended standard of care with at least 2 HIV care visits at least 3 months apart in a year.

Viral suppression: A viral load <200 copies/ml is the important to prevent progression to AIDS and to eliminate viral transmission. Studies have shown that viral suppression reduces transmission by 96%.

Because we don't have a way to directly measure clinic appointments, HIV laboratory tests reported to DPH are used as a proxy measure for HIV care visits. For example, having had at least one CD4 or viral load in a 12 month period is taken to indicate at least one HIV care visit in a year.