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HIV care cascade at Kaiser Permanente varies by sex and age
Theo Smart, 2014-10-23 08:00:00

Though there has been improving performance of healthcare delivery at each point of the HIV care cascade, from linkage to care through viral suppression, "success varies significantly by age and gender, even in an integrated care system with equal access to care,” Michael Horberg of the Mid-Atlantic Permanente Research Institute reported earlier this month at IDWeek 2014 in Philadelphia, United States.

Horberg presented the results of an analysis evaluating the care received over a three-year period by all people with HIV enrolled in the Kaiser Permanente (KP) integrated healthcare system, which operates in nine US states and the District of Columbia.

The study found that during the first two years of the study, the percentage of women who were linked to care after diagnosis was significantly lower compared with men, even though their retention once in care was higher. Likewise, a statistically lower percentage of women were taking antiretroviral therapy (ART) and maintaining viral suppression. However, these differences were not observed in 2012, the final year of the study – suggesting that quality improvement initiatives may be addressing gender differences.

Meanwhile, even though there was no difference in linkage to care after receiving an HIV diagnosis by age bracket (13-34, 35-54, and 55+), the increase in age was associated with significantly better retention, higher rates of ART prescription, and viral suppression.