Abstract
As many as 40-50% of persons living with HIV (PLWH) who once were in HIV care are no longer in care. It is estimated that these individuals account for over 60% of HIV transmissions. So, preventing the leaving of care and re-engaging PLWH with care are crucial if the HIV epidemic is to be brought under control. Clinicians can improve retention by keeping in close contact with patients. Governmental public health agencies have great expertise in finding and engaging in care persons with sexually transmitted infections. This expertise can be used to re-engage PLWH with HIV care, but it can only be utilized if the agencies know that someone is out of care. Data on who has left care are in the hands of HIV providers. This requires a close working relationship between HIV providers and public health agencies.
Highlights
Public health departments in the United States have been at the forefront of HIV education, testing and surveillance
This study showed that retention in care as measured by visit consistency nearly doubled with the opening of the youth specific clinic (31% to 57%)
Prevention science shows that persons with unsuppressed virus are 20 times more likely to transmit HIV and that out-of-care persons living with HIV (PLWH) are responsible for over 60% of transmissions [8,13]
Summary
Public health departments in the United States have been at the forefront of HIV education, testing and surveillance. Of HIV positive persons has been the purview of agencies and/or individuals who were not offen affiliated with public health departments; clinicians have contributed to surveillance efforts as many providers conduct HIV testing and report cases. Some health departments have used HIV-related laboratory surveillance data to identify individuals with significant gaps between HIV viral loads and/or CD4 counts [24,25].
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