How Well Are We Doing in Addressing Care and Support of People With HIV/AIDS?

摘要

In the past year the "HIV/AIDS Treatment Cascade" has been discussed as a tool for us to better understand the patterns of individuals who are identified as HIV-positive, referred to for care, begin medication treatment, and achieve the standard of undetectable viral load. The HIV/AIDS treatment cascade is a method to show, graphically, the numbers of those living with HIV/AIDS who are receiving the full benefits of the medical care and treatment they require. This model was first elucidated by Dr. Edward Gardner and colleagues, who developed estimates of how many people with HIV/AIDS in the United States are involved at various steps in the continuum of care from diagnosis through viral suppression. Their findings, published in the March 2011 issue of the Journal Clinical Infectious Diseases, identify a treatment cascade of a series of steps or levels ranging from diagnosis of HIV infection, linkage in care, initiation of antiretroviral therapy (ART), retention in care, and eventual viral suppression, meaning no detectable virus in the blood (Valdiserri, 2012). Gardner et al. demonstrated that in each level of the cascade, a significant number of those living with HIV in the United States "fall off," while only a minority of people with HIV actually achieve suppression of their viral infection (Valdisseri, 2012).