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The treatment cascade in the United States – good in Ryan White programmes, but overall picture for gay men is poor
Michael Carter, 2014-10-03 08:30:00
People living with HIV in the United States who receive their care through the Ryan White HIV/AIDS Program have good rates of retention and virological suppression, investigators report in the online edition of Clinical Infectious Diseases. Of the patients seen at least once in 2011, some 82% were retained in care and 73% achieved virological suppression.
These outcomes dwarf those seen for most people living with HIV in the US – previous reports have estimated that as few as 40% were retained in care and 19% had achieved virological suppression.
A second new report focuses on gay, bisexual and other men who have sex with men, demonstrating that outcomes continue to be unacceptably poor in this group. Of those who have ever been diagnosed with HIV, 51% were retained in care and 42% achieved virological suppression.
However, both new studies found that outcomes were poorer in younger people, African American people and some other ethnic groups.
Thanks to improvements in antiretroviral therapy, many people living with HIV have an excellent life expectancy. The best outcomes are seen in people with good engagement with the HIV treatment cascade: prompt diagnosis, linkage with care, retention in care, initiation of HIV therapy according to guidelines and achievement of an undetectable viral load (virological suppression).
While very good levels of retention in care and virological suppression have been achieved in western Europe, US outcomes are much more worrying.
Source:1
