PMID- 25394192
OWN - NLM
STAT- MEDLINE
DCOM- 20150319
LR  - 20200930
IS  - 1944-7884 (Electronic)
IS  - 1525-4135 (Linking)
VI  - 68
IP  - 2
DP  - 2015 Feb 1
TI  - Monitoring outcomes for newly diagnosed and prevalent HIV cases using a care 
      continuum created with New York city surveillance data.
PG  - 217-26
LID - 10.1097/QAI.0000000000000424 [doi]
AB  - BACKGROUND: The HIV care continuum has been used to show the proportion of 
      persons living with HIV/AIDS (PWHA) who are engaged in each stage of HIV care. We 
      present 1 care continuum for persons newly diagnosed with HIV and 1 for PWHA 
      using New York City HIV surveillance registry data. METHODS: Persons newly 
      diagnosed with HIV in 2011 or PWHA as of December 31, 2011, were included. We 
      constructed each continuum for persons engaged at each stage of HIV care and 
      calculated the proportion achieving each step as both dependent on or independent 
      of preceding steps. RESULTS: Of the 3408 newly diagnosed persons, 67% had timely 
      linkage to care (</=3 months after diagnosis), 58% were established in care 3-9 
      months after timely linkage, and 43% achieved viral suppression (</=200 copies/mL) 
      </=6 months after establishment in care; losses were highest from diagnosis to 
      linkage. Independent measures showed 84% linked, 72% established, and 61% 
      suppressed </=18 months after diagnosis. Of the 87,268 PWHA, 83% were in care in 
      2011 (>/=1 visit), 70% retained in care (>/=2 visits >/=3 months apart), and 52% 
      suppressed at their last visit; losses were highest from retention to 
      suppression. When measured independently, suppression increased to 58%. 
      CONCLUSIONS: A minority of persons newly diagnosed with HIV and a narrow majority 
      of PWHA achieved viral suppression and all intermediate care-related steps. 
      Outcomes measured independently of previous care-related steps were higher, 
      particularly for newly diagnosed persons. To improve outcomes among persons with 
      HIV and reduce transmissibility, clinical and public health efforts should focus 
      on linkage to care among newly diagnosed persons and viral suppression among 
      PWHA.
FAU - Wiewel, Ellen W
AU  - Wiewel EW
AD  - HIV Epidemiology and Field Services Program, Bureau of HIV Prevention and 
      Control, New York City Department of Health and Mental Hygiene, New York, NY.
FAU - Braunstein, Sarah L
AU  - Braunstein SL
FAU - Xia, Qiang
AU  - Xia Q
FAU - Shepard, Colin W
AU  - Shepard CW
FAU - Torian, Lucia V
AU  - Torian LV
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Acquir Immune Defic Syndr
JT  - Journal of acquired immune deficiency syndromes (1999)
JID - 100892005
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - CD4 Lymphocyte Count
MH  - Child
MH  - Child, Preschool
MH  - *Continuity of Patient Care
MH  - Disease Transmission, Infectious/prevention & control
MH  - Female
MH  - HIV Infections/*diagnosis/epidemiology/*therapy/transmission
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Middle Aged
MH  - New York City/epidemiology
MH  - Treatment Outcome
MH  - Viral Load
MH  - Young Adult
EDAT- 2014/11/14 06:00
MHDA- 2015/03/20 06:00
CRDT- 2014/11/14 06:00
PHST- 2014/11/14 06:00 [entrez]
PHST- 2014/11/14 06:00 [pubmed]
PHST- 2015/03/20 06:00 [medline]
AID - 10.1097/QAI.0000000000000424 [doi]
PST - ppublish
SO  - J Acquir Immune Defic Syndr. 2015 Feb 1;68(2):217-26. doi: 
      10.1097/QAI.0000000000000424.