sábado, 28 de julio de 2012

AIDS 2012 Abstract - Continuum of HIV care: differences in care and treatment by sex and race/ethnicity in the United States

IAS 2012 Daily Digest

This digest summarizes the Division of HIV/AIDS Prevention science presented on Friday, July 27. Visit the CDC at IAC 2012 page for other Daily Digests.

Continuum of HIV care: differences in care and treatment by sex and race/ethnicity in the United States

Lead Author: Irene Hall

Findings: Overall, only 25 percent of Americans with HIV have their virus under control. African-Americans are least likely to be in ongoing care and to have their virus under control. Thirty-four percent of African-Americans were in ongoing care, compared to 37 percent of Latinos and 38 percent of whites. Younger Americans are less likely to be in ongoing care and successfully treated; HIV care and viral suppression generally improved with age. There were no notable differences based on gender. Viral suppression was low across all groups when risk was assessed despite some variations across each stage of care.

Relevance: Most Americans with HIV are not getting HIV treatment needed for their health and to protect the health of their partners. The proportion of HIV-infected individuals in various subgroups who are engaged at each stage of care: testing, linkage to care, remaining in care, prescribed treatment and having a suppressed viral load were examined from CDC surveillance systems data. Researchers believe improvements are needed at each stage of the process, beginning with expanding HIV testing to identify Americans living with HIV who do not know they are infected and to ensure people have access to care, stay in care and remain on treatment.

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AIDS 2012 Abstract - Continuum of HIV care: differences in care and treatment by sex and race/ethnicity in the United States

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FRLBX05 - Oral Abstract

Continuum of HIV care: differences in care and treatment by sex and race/ethnicity in the United States

Presented by H Irene Hall (United States).

H.I. Hall¹, E.L. Frazier¹, P. Rhodes¹, D.R. Holtgrave², C. Furlow-Parmley¹, T. Tang³, K.M. Gray¹, S.M. Cohen¹, J. Skarbinski¹

¹Centers for Disease Control and Prevention, Atlanta, United States, ²Johns Hopkins Bloomberg School of Public Health, Baltimore, United States, ³ICF International, Atlanta, United States

Background: Early diagnosis of HIV, prompt linkage and sustained care, and antiretroviral therapy are associated with reduced individual morbidity and mortality and onward transmission of the virus. However, optimal levels of these indicators may not be achieved by all population groups with HIV.
Methods: Using data from CDC's National HIV Surveillance System, we determined the number of persons living with HIV aware and unaware of their infection using back-calculation models, and the percentage of persons linked to care within three months of diagnosis based on CD4 and viral load tests. We estimated the percentages of persons retained in care, prescribed antiretroviral therapy, and with viral suppression using data from the Medical Monitoring Project, a surveillance system of persons in HIV care in select areas representative of all such persons in the United States. Using these data, we determined the continuum of care indicators for persons with HIV by sex and race/ethnicity.
Results: Of the estimated 1,148,200 persons living with HIV in 2009 in the United States, 869,000 (76%) were male, 510,600 (44%) black or African American, and 220,400 (19%) Hispanic or Latino. The percentages of females diagnosed, linked to care, retained in care, and prescribed ART were slightly higher than for males but there were no substantial differences in viral suppression. The percentages were lower in each stage of the continuum for blacks/African Americans and Hispanics/Latinos compared with whites. Overall, 857,276 persons with HIV were not virally suppressed, including 75% of males, 79% of blacks/ African Americans, 74% of Hispanics/Latinos, and 70% of whites. Numbers were too small to present for other races.
Conclusions: Disparities exist in each step of the continuum for blacks/African Americans and Hispanics/Latinos. Additional efforts are needed to ensure that all persons with HIV get optimal care, reduce disparities, and ultimately reduce HIV transmission.