HIV Diagnosis and Care Critical To Preventing Spread Of Virus To Others

Medical Research
Jacek Skarbinski, MD
Original Article:

Dr. Skarbinski: Previous research has indicated that HIV diagnosis and viral suppression are important prevention tools that can help reduce continued transmission. However, this analysis is the first to estimate precisely what proportion of transmission can be attributed to individuals engaged in 5 stages of HIV care – including those who are unaware of their infection, those who are retained in care, and those who have their virus under control through treatment.

Our analysis shows that more than 90 percent of new HIV infections in the United States could be averted by diagnosing people living with HIV and ensuring they receive prompt, ongoing care and treatment. It also shows that the further people progress in HIV care, the less likely they are to transmit their virus.

More specifically, the analysis shows that 30 percent of new HIV infections were transmitted from people who did know they were infected, highlighting the importance of getting tested. People who had been diagnosed were less likely to transmit their infection, in part because people who know they have HIV are more likely to take steps to protect their partners from infection.

Finally, the model suggests that simply being in care can help people living with HIV avoid transmission of their virus. According to the model, people who were engaged in ongoing HIV care, but not prescribed antiretroviral treatment, were half as likely (51.8 percent) as those who are diagnosed but not in care to transmit their virus. Being prescribed HIV treatment further lowers the risk that a person will pass the virus to others. People who were successfully keeping the virus under control through treatment were 94 percent less likely than those who did not know they were infected to transmit their virus. But, previous national estimates have indicated that just 30 percent of people with HIV have reached this critical step in care.

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