Abstract
Objectives:Assess outcomes along the care continuum for HIV-infected people who inject drugs (PWID), by type of facility and stage of infection at diagnosis. Methods:Data reported by 28 jurisdictions to the National HIV Surveillance System by December 2014 were used to identify PWID aged ≥13 years, diagnosed with HIV infection before December 31, 2013. Analyses used the CDC definition of linkage to care (LTC), retention in care (RIC), and viral suppression (VS), and are stratified by age, sex, race/ethnicity, and type of facility and stage of HIV infection at diagnosis. Results:Of 1,409 PWID diagnosed with HIV in 2013, 1,116 (79.2%) were LTC with the lowest percentages among males (78.4%); blacks (77.5%) ages 13-24 years (69.0%); those diagnosed in early stage infection (71.6%); and at screening, diagnostic, or referral agencies (60.0%). Of 80,958 PWID living with HIV in 2012, 40,234 (49.7%) were RIC and 34,665 (42.8%) achieved VS. The lowest percentages for RIC and VS were among males (47.1% and 41.3% respectively); those diagnosed with late stage disease (47.1% and 42.4%); and young people. Whites had the lowest RIC (47.0%) while blacks had the lowest VS (41.1%). Conclusion:Enhanced LTC activities are needed for PWID diagnosed at screening, diagnostic or referral agencies versus those diagnosed at inpatient or outpatient settings, especially among young people and blacks diagnosed in early stage infection. Less than half of PWID are retained in care or reach viral suppression indicating the need for continued engagement and return to care activities over the long term.
Highlights
The National HIV/AIDS] HIV infection (AIDS) Strategy for the United States (NHAS) defines four primary goals: (1) reducing new human immunodeficiency virus (HIV) infections; (2) increasing access to care and improving health outcomes for people living with HIV; (3) reducing HIV-related disparities and health inequities; and (4) achieving a more coordinated
The linkage to care analysis was limited to people who inject drugs (PWID) who were diagnosed with HIV infection during 2013
CDC has adopted a high-impact prevention approach to advance the goals of the National HIV/AIDS Strategy by using a combination of scientifically proven, cost-effective, and scalable interventions targeted to PWID and other populations at greatest risk for HIV infection [24]
Summary
The National HIV/AIDS Strategy for the United States (NHAS) defines four primary goals: (1) reducing new human immunodeficiency virus (HIV) infections; (2) increasing access to care and improving health outcomes for people living with HIV; (3) reducing HIV-related disparities and health inequities; and (4) achieving a more coordinated1874-6136/16 2016 Bentham Open128 The Open AIDS Journal, 2016, Volume 10 national response to the HIV epidemic [1]. In 2013 IDU was the third most commonly reported risk factor for HIV infection in the United States after male-to-male sexual contact and heterosexual contact, and IDU was the only known risk factor for an estimated 6.6% of HIV infection diagnoses (5.1% of males and 12.4% of females) [7]. For both male and female PWID almost half of HIV infections in 2013 were among blacks/African Americans. Among male PWID, Hispanics/Latinos and whites each accounted for just under 25% of HIV diagnoses, while among females whites accounted for 34% and Hispanics/Latinos for 15% [7]
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