The Spectrum of Engagement in HIV Care and its Relevance to Test-and-Treat Strategies for Prevention of HIV Infection

For individuals with human immunodeficiency virus (HIV) infection to fully benefit from potent combination antiretroviral therapy, they need to know that they are HIV infected, be engaged in regular HIV care, and receive and adhere to effective antiretroviral therapy. Test-and-treat strategies for H...

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Bibliographic Details
Published in:Clinical infectious diseases 2011-03, Vol.52 (6), p.793-800
Main Authors: Gardner, Edward M., McLees, Margaret P., Steiner, John F., del Rio, Carlos, Burman, William J.
Format: Article
Language:English
Subjects:
AIDS
Anti-HIV Agents - therapeutic use
Antiretroviral drugs
Antiretroviral Therapy, Highly Active - methods
Antiretrovirals
Biological and medical sciences
Disease prevention
Disease transmission
Epidemics
Highly active antiretroviral therapy
HIV
HIV infections
HIV Infections - diagnosis
HIV Infections - drug therapy
HIV Infections - prevention & control
HIV/AIDS
Human immunodeficiency virus
Human viral diseases
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infectious diseases
Medical sciences
Medical treatment
Medications
Patient Acceptance of Health Care - statistics & numerical data
Patient care
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Sexually transmitted diseases
United States
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Viral load
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Summary:For individuals with human immunodeficiency virus (HIV) infection to fully benefit from potent combination antiretroviral therapy, they need to know that they are HIV infected, be engaged in regular HIV care, and receive and adhere to effective antiretroviral therapy. Test-and-treat strategies for HIV prevention posit that expanded testing and earlier treatment of HIV infection could markedly decrease ongoing HIV transmission, stemming the HIV epidemic. However, poor engagement in care for HIV-infected individuals will substantially limit the effectiveness of test-and-treat strategies. We review the spectrum of engagement in care for HIV-infected individuals in the United States and apply this information to help understand the magnitude of the challenges that poor engagement in care will pose to test-and-treat strategies for HIV prevention.
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciq243