U.S. HIV Treatment Cascade
The HIV care continuum, also known as the HIV treatment cascade, is a model used at the national, state, and local level to visualize the distribution of services to people living with HIV/AIDS across the entire continuum of care.
The continuum has five main stages:
- HIV Infection/Diagnosis: The HIV care continuum begins with an HIV infection. However, according to the CDC approximately 20% of the 1.1 million people living with HIV in the U.S. are undiagnosed. Those unaware of their status are not accessing the care and treatment they need and may be unknowingly passing the virus to others.
- Linkage to care: Following an HIV diagnosis, it is important for individuals to be linked to a healthcare provider who can connect them to treatment and other services need to help them stay as healthy as possible and prevent the passing HIV to others.
- Retention in care: Individuals are staying regularly engaged HIV medical care.
- Antiretroviral therapy (ART): ART therapy is the recommended treatment for HIV infection. Antiretrovirals are drugs that are used to prevent a retrovirus, such as HIV, from making more copies of itself.
- Suppression of viral load: By regularly taking ART, individuals can achieve viral suppression, meaning a very low level of HIV in their blood. Lowering the amount of HIV in the blood with medicines can keep individuals healthy, help them live longer, and greatly reduce their chances of passing the virus on to others.
According to the CDC, only 25% people living with HIV in the U.S. have achieved viral suppression thus indicating that the other 75% have not been successfully supported throughout the HIV care continuum. The graph indicates that within every stage of the continuum, there is a drop off at the success of individuals being linked to care, retained in care, and receiving HIV medical treatment.
Youth Treatment Cascade
The graph above displays the continuum of care for youth in the U.S. ages 13-29. As similarly indicated in the overall HIV care continuum, within every stage of the continuum, there is a drop off at the success of youth being linked to care, retained in care, and receiving HIV medical treatment.
The data indicates that approximately 40% of HIV-infected youth are diagnosed, while only 25% linked to medical care, 11% are in retained in care, and less than 6% of HIV-infected youth in the U.S. remain virally suppressed. Therefore, youth-focused interventions are necessary to improve the HIV cascade for adolescents and young adults.
Zanoni, B.C., & Mayer, K. H. (2014). The Adolescent and Young Adult HIV Cascade of Care in the United States: Exaggerated Health Disparities. AIDS Patient Care and STDs, 28(3) 128-135.