The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection.

For individuals with human immunodeficiency virus (HIV) infection to fully benefit from potent combination antiretroviral therapy, they need to know that they are HIV infected, be engaged in regular HIV care, and receive and adhere to effective antiretroviral therapy. Test-and-treat strategies for HIV prevention posit that expanded testing and earlier treatment of HIV infection could markedly decrease ongoing HIV transmission, stemming the HIV epidemic. However, poor engagement in care for HIV-infected individuals will substantially limit the effectiveness of test-and-treat strategies. We review the spectrum of engagement in care for HIV-infected individuals in the United States and apply this information to help understand the magnitude of the challenges that poor engagement in care will pose to test-and-treat strategies for HIV prevention.

[1]  Christopher Dye,et al.  Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model , 2009, The Lancet.

[2]  J. Bradford,et al.  Retention in care of persons newly diagnosed with HIV: outcomes of the Outreach Initiative. , 2007, AIDS patient care and STDs.

[3]  S. Twu,et al.  Decreased HIV transmission after a policy of providing free access to highly active antiretroviral therapy in Taiwan. , 2004, The Journal of infectious diseases.

[4]  W. Heneine,et al.  Prevalence of transmitted drug resistance associated mutations and HIV-1 subtypes in new HIV-1 diagnoses, U.S.–2006 , 2010, AIDS.

[5]  G. Rutherford,et al.  Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda , 2006, AIDS.

[6]  C. del Rio,et al.  Spatial Clustering of HIV Prevalence in Atlanta, Georgia and Population Characteristics Associated with Case Concentrations , 2011, Journal of Urban Health.

[7]  S. Holmberg,et al.  Efficacy of a brief case management intervention to link recently diagnosed HIV-infected persons to care , 2005, AIDS.

[8]  Amalio Telenti,et al.  Antiretroviral Treatment of Adult HIV Infection2010 Recommendations of the International AIDS Society–USA Panel , 2010 .

[9]  Isma'il ibn Ali al-Sadiq.  AIDS , 1986, The Lancet.

[10]  L. Hurley,et al.  Effects of Depression and Selective Serotonin Reuptake Inhibitor Use on Adherence to Highly Active Antiretroviral Therapy and on Clinical Outcomes in HIV-Infected Patients , 2008, Journal of acquired immune deficiency syndromes.

[11]  H. Gershengorn,et al.  A tale of two futures: HIV and antiretroviral therapy in San Francisco. , 2000, Science.

[12]  C. Collins,et al.  Can we treat our way out of HIV? , 2010, AIDS research and human retroviruses.

[13]  C. Logie,et al.  Meta-analysis of health and demographic correlates of stigma towards people living with HIV , 2009, AIDS care.

[14]  B. Meyerson,et al.  Assessing HIV care and unmet need: Eight data bases and a bit of perseverance , 2008, AIDS care.

[15]  M. Wallace,et al.  Erectile dysfunction and hypogonadism among men with HIV. , 2007, AIDS patient care and STDs.

[16]  S. Kippax,et al.  Modelling the effect of combination antiretroviral treatments on HIV incidence , 2001, AIDS.

[17]  E. Wilkins,et al.  National review of first treatment change after starting highly active antiretroviral therapy in antiretroviral‐naïve patients , 2007, HIV medicine.

[18]  D. Descamps,et al.  Predictors of virologic failure and resistance in HIV-infected patients treated with nevirapine- or efavirenz-based antiretroviral therapy. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[19]  E. Vittinghoff,et al.  Decreases in Community Viral Load Are Accompanied by Reductions in New HIV Infections in San Francisco , 2010, PloS one.

[20]  Shari Messinger,et al.  HIV transmission risk behaviors among HIV-infected persons who are successfully linked to care. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[21]  Mardge H. Cohen,et al.  Factors and Temporal Trends Associated With Highly Active Antiretroviral Therapy Discontinuation in the Women's Interagency HIV Study , 2005, Journal of acquired immune deficiency syndromes.

[22]  J. Kahn,et al.  Estimation of unmet need for HIV primary medical care: a framework and three case studies. , 2005, AIDS education and prevention : official publication of the International Society for AIDS Education.

[23]  R. Conviser,et al.  The role of ancillary services in client-centred systems of care , 2002, AIDS care.

[24]  David R. Holtgrave,et al.  Infections Prevented by Increasing HIV Serostatus Awareness in the United States, 2001 to 2004 , 2008, Journal of acquired immune deficiency syndromes.

[25]  U. Boehmer,et al.  Retention challenges for a community-based HIV primary care clinic and implications for intervention. , 2007, AIDS patient care and STDs.

[26]  P. Pezzotti,et al.  Factors associated with the failure of HIV-positive persons to return for scheduled medical visits , 2002, HIV clinical trials.

[27]  R. Redfield,et al.  Evaluation of initial CD4+ T cell counts in individuals with newly diagnosed human immunodeficiency virus infection, by sex and race, in urban settings. , 2002, The Journal of infectious diseases.

[28]  M. Suarez‐Almazor,et al.  Retention in care: a challenge to survival with HIV infection. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[29]  Mardge H. Cohen,et al.  Association of hepatitis C virus and HIV infection with subclinical atherosclerosis in the women's interagency HIV study , 2009, AIDS.

[30]  J. Castilla,et al.  Combined antiretroviral treatment and heterosexual transmission of HIV-1: cross sectional and prospective cohort study , 2010, BMJ : British Medical Journal.

[31]  G. Marks,et al.  Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA , 2006, AIDS.

[32]  J. Steiner,et al.  Antiretroviral medication adherence and the development of class-specific antiretroviral resistance , 2009, AIDS.

[33]  H. Sørensen,et al.  Declining Prevalence of HIV-Infected Individuals at Risk of Transmitting Drug-Resistant HIV in Denmark during 1997–2004 , 2005, Antiviral therapy.

[34]  J. J. Henning,et al.  Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents, January 28, 2000 , 1998, HIV clinical trials.

[35]  髙折 晃史,et al.  19th Conference on Retroviruses and Opportunistic Infections , 2012 .

[36]  B. Gazzard,et al.  Data linkage reduces loss to follow-up in an observational HIV cohort study. , 2010, Journal of clinical epidemiology.

[37]  P. Harrigan,et al.  Improved virological outcomes in British Columbia concomitant with decreasing incidence of HIV type 1 drug resistance detection. , 2010, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[38]  T. Frieden,et al.  Risk factors for delayed initiation of medical care after diagnosis of human immunodeficiency virus. , 2008, Archives of internal medicine.

[39]  Gary Marks,et al.  Meta-Analysis of High-Risk Sexual Behavior in Persons Aware and Unaware They are Infected With HIV in the United States: Implications for HIV Prevention Programs , 2005, Journal of acquired immune deficiency syndromes.

[40]  S. Coleman,et al.  The provider role in client engagement in HIV care. , 2007, AIDS patient care and STDs.

[41]  Y. Yazdanpanah,et al.  Incidence rate and risk factors for loss to follow-up in HIV-infected patients from five French clinical centres in Northern France – January 1997 to December 2006 , 2008, Antiviral therapy.

[42]  J. Bradford.  The promise of outreach for engaging and retaining out-of-care persons in HIV medical care. , 2007, AIDS patient care and STDs.

[43]  H. Gershengorn,et al.  Could widespread use of combination antiretroviral therapy eradicate HIV epidemics? , 2002, The Lancet. Infectious diseases.

[44]  Lisa M. Lee,et al.  Estimation of HIV incidence in the United States. , 2008, JAMA.

[45]  J. Margolick,et al.  Interruption and Discontinuation of Highly Active Antiretroviral Therapy in the Multicenter AIDS Cohort Study , 2005, Journal of acquired immune deficiency syndromes.

[46]  G. Guyatt,et al.  Adherence to antiretroviral therapy in sub-Saharan Africa and North America: a meta-analysis. , 2006, JAMA.

[47]  Connie Celum,et al.  Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis , 2010, The Lancet.

[48]  David R Bangsberg,et al.  Less than 95% adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression. , 2006, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[49]  M. B. Pounds,et al.  Making the connection: the importance of engagement and retention in HIV medical care. , 2007, AIDS patient care and STDs.

[50]  A. Westfall,et al.  Missed visits and mortality among patients establishing initial outpatient HIV treatment. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[51]  R. Weber,et al.  Durability and outcome of initial antiretroviral treatments received during 2000--2005 by patients in the Swiss HIV Cohort Study. , 2008, The Journal of infectious diseases.

[52]  W. Duffus,et al.  Patterns of engagement in care by HIV-infected adults: South Carolina, 2004–2006 , 2009, AIDS.

[53]  Evan Wood,et al.  The case for expanding access to highly active antiretroviral therapy to curb the growth of the HIV epidemic , 2006, The Lancet.

[54]  A. Mocroft,et al.  Reasons for stopping antiretrovirals used in an initial highly active antiretroviral regimen: increased incidence of stopping due to toxicity or patient/physician choice in patients with hepatitis C coinfection. , 2005, AIDS research and human retroviruses.

[55]  E. Funkhouser,et al.  Factors Associated with Delayed Initiation of HIV Medical Care Among Infected Persons Attending a Southern HIV/AIDS Clinic , 2006, Southern medical journal.

[56]  L. Hurley,et al.  Review of Medical Encounters in the 5 Years Before a Diagnosis of HIV-1 Infection: Implications for Early Detection , 2003, Journal of acquired immune deficiency syndromes.

[57]  T. Hallett,et al.  Examining the promise of HIV elimination by ‘test and treat’ in hyperendemic settings , 2010, AIDS.

[58]  Stephen P. Boyd,et al.  Late Diagnosis of HIV Infection: Trends, Prevalence, and Characteristics of Persons Whose HIV Diagnosis Occurred Within 12 Months of Developing AIDS , 2006, Journal of acquired immune deficiency syndromes.

[59]  E. Gardner,et al.  Risk-Based Human Immunodeficiency Virus (HIV) Testing Fails to Detect the Majority of HIV-Infected Persons in Medical Care Settings , 2006, Sexually transmitted diseases.

[60]  Matthias Egger,et al.  Sexual transmission of HIV according to viral load and antiretroviral therapy: systematic review and meta-analysis , 2009, AIDS.

[61]  H. Cabral,et al.  Program design and evaluation strategies for the Special Projects of National Significance Outreach Initiative. , 2007, AIDS patient care and STDs.

[62]  Evan Wood,et al.  Longitudinal community plasma HIV-1 RNA concentrations and incidence of HIV-1 among injecting drug users: prospective cohort study , 2009, BMJ : British Medical Journal.

[63]  P. Rhodes,et al.  Undiagnosed HIV Prevalence Among Adults and Adolescents in the United States at the End of 2006 , 2009, Journal of acquired immune deficiency syndromes.

[64]  Ottavia Viganò,et al.  Abacavir hypersensitivity reaction after switching from the twice-daily to the once-daily formulation. , 2007, AIDS patient care and STDs.

[65]  S. Vermund,et al.  Addressing research priorities for prevention of HIV infection in the United States. , 2010, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[66]  JD Lundgren,et al.  Loss to follow‐up in an international, multicentre observational study , 2008, HIV medicine.

[67]  R. Hogg,et al.  Expanding HAART Treatment to All Currently Eligible Individuals under the 2008 IAS-USA Guidelines in British Columbia, Canada , 2010, PloS one.

[68]  P. G. Choe,et al.  One‐year adherence to clinic visits after highly active antiretroviral therapy: a predictor of clinical progress in HIV patients , 2007, Journal of internal medicine.

[69]  Douglas D. Richman,et al.  Antiretroviral Treatment of Adult HIV Infection , 2008 .

[70]  G. Marks,et al.  Brief Strengths-Based Case Management Promotes Entry Into HIV Medical Care: Results of the Antiretroviral Treatment Access Study-II , 2008, Journal of acquired immune deficiency syndromes.

[71]  Andrew J Copas,et al.  Early predictors of mortality from Pneumocystis jirovecii pneumonia in HIV-infected patients: 1985-2006. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[72]  A. Levy,et al.  Expanded access to highly active antiretroviral therapy: a potentially powerful strategy to curb the growth of the HIV epidemic. , 2008, The Journal of infectious diseases.

[73]  A. Davidson,et al.  Epidemiology of Pneumocystis carinii pneumonia in an era of effective prophylaxis: the relative contribution of non-adherence and drug failure , 2000, AIDS.

[74]  S. Hammer,et al.  Antiretroviral therapy for HIV infection in 1998: updated recommendations of the International AIDS Society-USA Panel. , 1997, JAMA.

[75]  A. Fauci,et al.  Universal voluntary testing and treatment for prevention of HIV transmission. , 2009, JAMA.

[76]  C. Sabin,et al.  The late diagnosis and consequent short-term mortality of HIV-infected heterosexuals (England and Wales, 2000–2004) , 2006, AIDS.

[77]  Melissa R. Pfeiffer,et al.  Population prevalence of reported and unreported HIV and related behaviors among the household adult population in New York City, 2004 , 2008, AIDS.

[78]  J. Bradford,et al.  HIV System Navigation: an emerging model to improve HIV care access. , 2007, AIDS patient care and STDs.

[79]  Anne M Johnson,et al.  Changes in the risk of death after HIV seroconversion compared with mortality in the general population. , 2008, JAMA.

[80]  F. Maggiolo,et al.  Effect of Adherence to HAART on Virologic Outcome and on the Selection of Resistance-Conferring Mutations in NNRTI- or PI-Treated Patients , 2007, HIV clinical trials.

[81]  P. Francioli,et al.  Long-term trends of HIV type 1 drug resistance prevalence among antiretroviral treatment-experienced patients in Switzerland. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[82]  G. L’italien,et al.  Determinants of discontinuation of initial highly active antiretroviral therapy regimens in a US HIV‐infected patient cohort * , 2006, HIV medicine.

[83]  B. Yip,et al.  The Combined Effect of Modern Highly Active Antiretroviral Therapy Regimens and Adherence on Mortality Over Time , 2009, Journal of acquired immune deficiency syndromes.