The HIV care continuum is the sequence of engagements with testing, treatment, and prevention services required for optimal management of HIV risk or HIV infection. For patients who receive an HIV diagnosis, timely entry into HIV medical care is essential for the initiation of ART. Retention in care is critical to long-term adherence to treatment, one of the key factors determining the success of therapy both for treatment of the person living with HIV and for prevention of transmission to uninfected sexual partners.1,2,3

While treatment and prevention objectives can be advanced via a robust HIV care continuum that maximizes testing and referral to care, a number of barriers can impede linkage of newly HIV-diagnosed individuals to care. Barriers to linkage may include health care system factors, social factors, and patient factors.4

The International Association of Physicians in AIDS Care (IAPAC) has developed a set of evidence-based recommendations to optimize the HIV care continuum.1,2 The recommendations address a range of critical issues, including
• Optimizing the HIV care environment
• Increasing HIV testing coverage and linkage to care
• Increasing HIV treatment coverage
• Increasing retention in care, ART adherence, and viral suppression
• Special issues affected adolescents
• Metrics and monitoring

RESOURCES AVAILABLE ONLINE

Summary table of the IAPAC GUIDELINES FOR OPTIMIZING THE HIV CARE CONTINUUM
FOR ADULTS AND ADOLESCENTS
http://iapac.org/uploads/IAPAC-2015-Guidelines-Summary-Table-093015.pdf

PowerPoint presentation of the IAPAC guidelines
http://aidsetc.org/resource/iapac-guidelines-optimizing-hiv-care-continuum-adults-and-adolescents

References:

  1. Thompson MA, Mugavero MJ, Amico KR, et al. Guidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: evidence-based recommendations from an International Association of Physicians in AIDS Care panel. Ann Intern Med. 2012 Jun 5;156(11):817-33, W-284, W-285, W-286, W-287, W-288, W-289, W-290, W-291, W-292, W-293, W-294. doi: 10.7326/0003-4819-156-11-201206050-00419. Epub 2012 Mar 5.
  2. International Advisory Panel on HIV Care Continuum Optimization. IAPAC Guidelines for Optimizing the HIV Care Continuum for Adults and Adolescents. J Int Assoc Provid AIDS Care. 2015 Nov-Dec;14 Suppl 1:S3-S34. doi: 10.1177/2325957415613442. Epub 2015 Nov 2.
  3. Gardner EM, McLees MP, Steiner JF, et al. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis. 2011 Mar 15;52(6):793-800. doi: 10.1093/cid/ciq243.
  4. Bauman LJ, Braunstein S, Calderon Y, et al. Barriers and facilitators of linkage to HIV primary care in New York City. J Acquir Immune Defic Syndr. 2013 Nov 1;64 Suppl 1:S20-6. doi: 10.1097/QAI.0b013e3182a99c19.