There are significant age disparities across the continuum of care for those with HIV, according to research published in JAMA Internal Medicine.
“Across all populations, far too few Americans with HIV receive the care they need to stay healthy and reduce the risk of transmission,” Irene Hall, PhD, CDC epidemiologist, told Infectious Disease News. “According to our research, gaps in care are largest among African-Americans and young people. Moving forward, improving care for all HIV-infected people will be critical to achieving the goal of an AIDS-free generation in America.”
Hall and colleagues used data from the National HIV Surveillance System and the Medical Monitoring Project to determine the prevalence of HIV and the care and treatment that they were receiving. They calculated differences between groups by age, sex, race/ethnicity and transmission category across several steps in the continuum of care.
There were an estimated 1,148,200 people with HIV in the United States in 2009, and 18% did not know they were infected. Among those with HIV, 66% were linked to care, 37% were retained in care, 33% were prescribed ART and 25% had a suppressed viral load.
Young people aged 13 to 24 years were less likely to be aware of their infection: only 40.5% were diagnosed. Among people aged 25 to 34 years, 15% had viral suppression, compared with 36% of those aged 55 to 64 years. In addition, only 28% of peopled aged 25 to 34 years were retained in care, compared with 46% of people aged 55 to 64 years.
“Despite all of the progress we’ve made during the past 30 years, this study paints a stark picture: most people living with HIV in America today are not getting the care and treatment they need for their health and to protect their partners,” Hall said. “These data especially underscore the urgent need to overcome barriers to HIV testing and ongoing care among African-Americans, Hispanics or Latinos and younger people. By focusing intensively on confronting the underlying causes of these disparities, we can help more people living with HIV protect their health and reduce transmission to others.”
Hall said that health care providers can play a critical role in strengthening care among those living with HIV by implementing CDC’s recommendations for routine HIV testing; prioritizing retention in care and treatment adherence; and providing critical prevention services. She also said that CDC is pursuing a “High-Impact Prevention” approach, which will expand testing efforts, develop and implement behavior-change programs to reduce risk behaviors and prioritize services for those living with HIV.
Disclosure: The researchers report no relevant financial disclosures.