Among the most popular videos on AIDS.gov’s YouTube channel is a short animated video about the HIV care continuum produced in 2012. The video’s producer, Gilead, recently updated the video to reflect new data from CDC on the stages of the continuum and help viewers understand the steps to help people with HIV stay healthy, live longer, and dramatically reduce the likelihood of viral transmission.
The HIV Care Continuum
The HIV care continuum—sometimes referred to as the HIV treatment cascade—outlines the sequential stages of HIV medical care that people living with HIV go through from initial diagnosis to achieving the goal of viral suppression (a very low level of HIV in the body). The stages are: diagnosis of HIV infection, linkage to care, retention in care, receipt of antiretroviral therapy (ART), and achievement of viral suppression. Many of us in the HIV field at the Federal, state, and local levels use the continuum to identify gaps in services, develop strategies to improve engagement in care, and target resources appropriately.
Despite advances in HIV testing and treatment, there continue to be significant gaps in the HIV care continuum. For example, according to the latest CDC data, of the 1.2 million people living with HIV in the U.S. in 2011, an estimated 14% (approximately 1 in 7 people living with HIV) were unaware of their infection and therefore not accessing the care and treatment they need to stay healthy and reduce the likelihood of transmitting the virus to their partners.
In addition, people living with HIV are dropping off at every subsequent stage of the continuum. Of the 1.2 million Americans living with HIV in 2011, CDC found that only 3 out of 10 had successfully navigated all stages of the continuum and had the virus under control with HIV medication.
And, recently, CDC published a study in JAMA Internal Medicine providing the first U.S. estimates of the number of HIV transmissions from people engaged at the five stages of the continuum. The study estimated that 91.5 percent of new HIV infections in 2009 were attributable to people with HIV who were not in medical care, including those who didn’t know they were infected. In comparison, less than six percent of new infections could be attributed to people with HIV who were in care and receiving ART. In other words, according to this research, 9 in 10 new HIV infections in the United States could be prevented through early diagnosis and prompt, ongoing care and treatment.
Federal Efforts to Address the Continuum
Given what we know about gaps in the continuum, President Obama signed an Executive Order in July 2013, directing Federal departments to prioritize addressing the HIV care continuum as they continue to implement the National HIV/AIDS Strategy.
As part of ongoing efforts across the Federal government to sharpen our focus on improving outcomes across the HIV care continuum, last month HHS announced the launch of Positive Spin, a digital educational tool that uses personal storytelling to provide information about the HIV care continuum and to promote the importance of getting into treatment and staying in care for people with HIV.
Featuring the personal experiences of five HIV-positive gay black men who have successfully navigated the continuum, Positive Spin is just one of many efforts to encourage people living with HIV to get tested and treated so that they can stay healthy and prevent the spread of HIV to others.
I encourage you to access Positive Spin at https://positivespin.hiv.gov and share the videos and resources with others—along with this continuum overview video—as part of your ongoing efforts to educate clients, partners and allies about how improvements along each step of the continuum will help us achieve an AIDS-free generation.
To learn more about the HIV care continuum, visit AIDS.gov’s HIV Care Continuum page.
Please note that featuring this video on blog.aids.gov does not constitute an endorsement by either AIDS.gov or the U.S. Department of Health and Human Services (HHS) of the private entity’s