HIV Continuum of Care

The continuum of engagement in HIV care is a framework for understanding the status of HIV care and treatment in the United States (Cheever 2007). An individual person living with HIV (PLWH) may go through several stages and may also return to earlier stages of the continuum throughout his/her life (Cheever 2007). In order to understand how HIV care delivery fits into the continuum of care, Mugavero and colleagues created a framework through which care services can be better understood, with the ultimate goal of viral load suppression (Mugavero 2011). Viral load suppression not only improves individual health, but it also reduces HIV transmission on a population level (Das 2010, Montaner 2010). As there is mounting evidence that treatment of HIV with combination antiretroviral therapy (ART) reduces HIV transmission and HIV incidence (CDC 1994, Cohen 2011, Jia 2012), there has been more of a public health focus on treatment for everyone, and the DHHS guidelines also recently supported this (DHHS 2013). The continuum focuses on several steps of HIV service delivery, including diagnosis, linkage to care, retention in care, ART, and viral load suppression. (Background, Continuum of HIV care among Ryan White HIV/AIDS Program clients, U.S., 2010.)

This section features resources for HIV clinicians and clinical trainers that address each point along the HIV continuum of care, or HIV treatment cascade. (Image courtesy CDC)