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HIV Care Continuum

Education Packet

HIV Care Continuum – This packet is a compilation of recent fact sheets and other resources. You may wish to customize it to meet the needs or interests of particular groups, such as event participants, providers, patients, clients, or the general public. So please feel free to distribute all or part of this packet as either a printout or PDF.   


Fact Sheets and Infographics

Understanding the HIV Care Continuum (CDC) – This fact sheet provides an overview of what the HIV care continuum is, the differences between prevalence-based and diagnosis-based continuums of care, the steps in the HIV care continuum, how these steps are measured, and approaches for improving the outcomes at every step of the HIV care continuum.

What Is the HIV Care Continuum? (HIV.gov) – This fact sheet answers frequently asked questions about the continuum, including what the care continuum is, why it is considered important, what it shows, and how it is being used.

HIV Continuum of Care (Clinicalinfo.HIV.gov) – This glossary entry and associated infographic traces six steps along the HIV care continuum with the goal of reaching and maintaining an undetectable viral load. Also available in Spanish.

Health Communication Makes an Impact on the HIV Continuum of Care (Health Communication Capacity Collaborative) – This fact sheet/infographic highlights evidence indicating that health communication can make a measurable impact on the HIV care continuum. An associated Continuum of Care evidence fact sheet provides more detailed information about this topic, including evidence on the role of HIV-related health communication in community engagement, interpersonal communication, and mHealth (mobile health).

HIV Care Continuum Infographics (CDC) – This page has recent infographics on the continuum for the U.S. as a whole, as well as several specific groups. The infographics include:

Retention in Care – This resource examines several topics related to retention in HIV care: factors associated with poor retention in care; barriers patients face to remaining in care; and tips on communicating effectively with patients to help keep them engaged in care.

 

Reports, Guidelines, and Other Resources

The National HIV/AIDS Strategy (NHAS) for the United States: 2022-2025 (White House, December 2021) – This 98-page document outlines the framework and direction for U.S. policies, research, programs, and planning through 2025 in an effort to end the HIV epidemic by 2030. To evaluate progress toward its goals and objectives, the new NHAS establishes a series of indicators that track: knowledge of HIV status; HIV incidence and new diagnoses; use of pre-exposure prophylaxis; rates of linkage to care and viral suppression; HIV stigma; homelessness among people with HIV; and the implementation of LGBTQ-supportive policies and practices in schools.

HIV National Strategic Plan for the United States: A Roadmap to End the Epidemic – 2021-2025 (HIV.gov) – Released in 2021, the HIV Plan presents a framework for U.S. efforts to end the HIV epidemic. The Executive Summary (pages 1-5) outlines the HIV Plan’s key goals and objectives, many of which relate directly or indirectly to the HIV care continuum.  Core indicators and disparities indicators set specific targets for 2025 for increasing knowledge of HIV status, linkage to HIV care, and viral suppression, with particular emphasis on population groups heavily impacted by HIV. 

Selected National HIV Prevention and Care Outcomes in the United States (CDC) – This fact sheet summarizes recent outcomes for four national indicators specifically related to the HIV care continuum: knowledge of HIV serostatus (diagnosed HIV infection); linkage to HIV medical care; retention in HIV medical care; and viral suppression. Breakdowns for these indicators by gender are also provided.

Vital Signs: HIV Transmission Along the Continuum of Care – United States, 2016 (CDC) – This report provides evidence that, along the care continuum, HIV transmissions arise either from persons with HIV infection who have not received an HIV diagnosis, or from those who have a diagnosed infection that is not controlled (viral suppression has not been achieved).

Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data United States and 6 Dependent Areas, 2019 (CDC) – This report presents the results of focused analyses of U.S. HIV surveillance data to measure progress toward ending the HIV epidemic. It includes information on the stage of HIV disease at time of diagnosis, linkage to HIV medical care, viral suppression, prevalence-based HIV care continuum, HIV deaths and survival, use of pre-exposure prophylaxis (PrEP), and perinatal HIV infections. 

Core Indicators for Monitoring the Ending the HIV Epidemic Initiative (Early Release): National HIV Surveillance System Data Reported through December 2020; and Preexposure Prophylaxis (PrEP) Data Reported through September 2020 (CDC) – This report provides data on several of the six core indicators of the EHE initiative, including two – linkage to HIV care and viral suppression – are part of the HIV care continuum. These tables include data for states and selected counties. Breakdowns by gender, age, race/ethnicity, and transmission category are also provided.

Prevention IS Care (CDC) – This toolkit, developed as part of CDC’s Act Against AIDS initiative, is designed to help HIV care providers engage patients in care and transmission prevention. It includes materials that can be used to aid patients in understanding the importance of remaining in care, taking ART as prescribed, and practicing safer sexual behaviors to prevent acquisition of sexually transmitted diseases (STDs) and prevent transmission.

Using Community Health Workers to Improve Linkage and Retention in Care (Boston University School of Public Health and other organizations) – This set of resources, available on the TargetHIV website, was developed to help clinics integrate community health workers into an HIV multidisciplinary team model. It includes:

HIV Care Continuum Data for the New England States

AIDSVu Local Data – This resource includes extensive state and county-level HIV data for individual states, including data on the HIV care continuum. The care continuum data, when available, are presented in bar graph format, and are accessible from an “HIV Care Continuum” navigation button that appears directly under the AIDSVu map of each state. For your convenience, we are linking to each AIDSVu state report here: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont

Connecticut, Massachusetts, Rhode Island, and Vermont also have recent HIV care continuum data and reports posted on their state’s health department websites. These include:

HIV Continuum of Care, Connecticut, 2020 – These are annotated bar graphs summarizing data on the care continuum in the state. Information is also presented on how quickly persons are linked to care after their HIV diagnosis.

Massachusetts HIV/AIDS Epidemiologic Profile Statewide Report: Data as of 2/1/2021 – Figures 25 through 33 of this report summarize continuum of care data for Massachusetts for the years 2018 and 2019, with breakdowns by sex at birth, race/ethnicity, age at diagnosis, and primary mode of exposure.

Rhode Island HIV 90-90-90 Initiative – This web page describes the state’s 2020 goals of assuring that 90% of people living with HIV will know their status, 90% of people living with HIV will be engaged in HIV care, and 90% of people living with HIV will have viral suppression. The bottom of the page includes a bar graph chart illustrating the HIV care continuum in Rhode Island during 2018.

2017 Vermont HIV Annual Report – The last page of this report focuses on linkage to care and viral suppression of people diagnosed with HIV in Vermont during 2017 – the latest year for which the Vermont Department of Health has published data.

 

Selected Resources from AIDS Education and Training Centers (AETCs) and HRSA

Evidence-Informed Interventions for Women of Color with HIV (Special Projects of National Significance Models of Care and others, October 2021) – This resource includes enhanced tools for patient navigation and for peer linkage and re-engagement into HIV care.

Recovery Support Services Along the Continuum of Substance Use and HIV Treatment (Pacific AETC, September 2021) – This online course is designed to help participants understand the Recovery Support Services available for people with HIV and co-occurring substance use disorders. This training offers information and interactive activities to help integrate effective recovery support services at different stages along a continuum of care to improve patient retention and engagement.

Leveraging mHealth, Telehealth, and At-home Testing in Rural Areas: Implications for the HIV Care Continuum (South Central AETC and others, September 2021) – These training slides cover health inequities related to accessing culturally competent medical care, and discuss the role of rurality, and cultural norms on primary, secondary, and tertiary HIV prevention interventions.

The Intersection of HIV and Mental Health: Addressing Anxiety, Depression and Suicide Prevention (Pacific AETC, June 2021) – The purpose of this resource is to increase knowledge about the role of mental health in treatment adherence and retention in care, and to offer strategies and tools for people with HIV and mental health issues.

Engaging People with HIV in Care and Rapid Antiretroviral Therapy Programs to Help End the HIV Epidemic (HRSA CAREAction Newsletter, September 2019) – This issue includes information about entry into care and antiretroviral therapy (ART as key interventions, implementing rapid ART programs, barriers to care, and two brief case studies of Ryan White HIV/AIDS Program-funded agencies’ efforts to get people with HIV into care.

Communicating About Treatment as Prevention and Viral Suppression (HRSA CAREAction Newsletter, August 2019) – This issue includes information about the importance of treatment as prevention (TasP) and viral suppression in practice, communicating effectively with providers and patients about TasP and viral suppression, as well as brief case studies of Ryan White HIV/AIDS Program-funded agencies’ efforts to communicate about TasP and viral suppression.

 

The contents listed on this page are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, the New England AIDS Education and Training Center.