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The revolving door of HIV care: Revising the service delivery cascade to achieve the UNAIDS 95-95-95 goals
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The revolving door of HIV care: Revising the service delivery cascade to achieve the UNAIDS 95-95-95 goals
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Journal Article
The revolving door of HIV care: Revising the service delivery cascade to achieve the UNAIDS 95-95-95 goals
2021
Overview
Introduction Since 2014, the global public health community has recognized a set of targets for human immunodeficiency virus (HIV) known as “90-90-90,” an ambitious plan that called for the diagnosis of 90% of people living with HIV (PLHIV), antiretroviral therapy(ART) for 90% of those diagnosed HIV–positive, and viral suppression in 90% of those receiving ART by 2020 [1]. Population-level control of HIV will remain out of reach if many people initiating treatment disengage from ART for long periods of time, as they will have increased opportunity for viral load failure, morbidity, mortality [7], development of drug resistance, and viral transmission [8–11]. Clinical outcomes, such as viral load suppression, are not explicitly included in the cascade as long-term retention in care, the fourth stage in our cascade, is highly correlated with suppressed viral load [7,27], and our intention is to better understand PLHIV behavior as it relates to patterns of engagement, not the biological results of treatment. [...]the proposed cascade does not identify the facility at which people return to care or indicate how long they were disengaged.
Publisher
Public Library of Science,Public Library of Science (PLoS)
