![]() ![]() While HIV routine testing scale-up has resulted in earlier diagnosis and with the majority of persons successfully linking to care, the ability to remain in care, adhere to medication regimens, and achieve viral suppression has not been as successful. 10, 11ĭespite unequivocal evidence in support of HIV care engagement, it remains one of the most difficult steps of the HIV care continuum to achieve and maintain. 6– 10 Thus, the central tenet of prevention approaches such as treatment as prevention, which aims to treat infected persons with the goal of achieving individual and public health benefit, cannot be met if we are unable to fully engage HIV infected persons in care. 5 At a population level, when a person is fully engaged in care their risk of transmitting virus to others is also significantly decreased due to both decreased risk taking behaviors and decreased biological risk of transmission from being virally suppressed. 1– 4 Once engaged in care, those persons who are able to sustain engagement in care have higher rates of viral suppression. Patients who delay entry into care or miss visits within the first year of diagnosis have higher mortality. At an individual level, engagement and retention in care have been shown to improve immunological outcomes, decrease HIV-associated morbidity, and prolong survival. According to the HIV continuum of care, in order for HIV-infected persons to take full advantage of HIV care and treatment and achieve viral suppression, they must be engaged and retained in HIV care and receiving antiretroviral (ARV) therapy. ![]()
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