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Elements of the Care Continuum

Elements of the Care Continuum. Michael J. Mugavero, MD, MHSc Associate Professor of Medicine University of Alabama at Birmingham Birmingham, Alabama. FORMATTED: 12/09/15. New Orleans, Louisiana: December 15-17, 2015. National HIV/AIDS Strategy: 2020 Goals.

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Elements of the Care Continuum

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  1. Elements of the Care Continuum Michael J. Mugavero, MD, MHSc Associate Professor of Medicine University of Alabama at Birmingham Birmingham, Alabama FORMATTED: 12/09/15 New Orleans, Louisiana: December 15-17, 2015

  2. National HIV/AIDS Strategy: 2020 Goals Increase HIV serostatus awareness to at least 90% Slide 10 of 38 Increase retention among persons diagnosed to at least 90% Increase linkage to care w/in 1 month of Dx to at least 85% Increase proportion of persons diagnosed with viral suppression to at least 80% Ulett et al. AIDS Pt Care STDs 2009;23:41-49, Mugavero et al. Clin Infect Dis 2011;52(S2).

  3. Slide 13 of 38 ~90% of HIV Transmissions in 2009 in the US Skarbinski et al. JAMA Intern Med 2015;175

  4. Slide 21 of 38 Adapted from: Giordano TP (2012) Measuring retention in HIV care. www.medscape.com.

  5. Slide 30 of 38 Guidelines: Monitoring ART Adherence Plasma HIV RNA (viral load) is the biological correlate of the adherence behavior, NOT a screening tool for adherence! Thompson MA et al. Ann Intern Med 2012;156

  6. Slide 38 of 38 Take Home Points • Engagement across the continuum of HIV care is dynamic and impacts individual & population health • Systematic monitoring of engagement in care and ART adherence is foundational • Prognostic value of missed visits • Predictive value of self-reported NON-adherence • Evidence-based interventions for engagement in care and ART adherence amenable to clinical settings • Partnerships with public health and community agencies essential to improve continuum outcomes

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