Reflecting a dire missing link in the nation’s attempt to control the virus, new research shows that only one in five Americans on Medicaid who receive an HIV diagnosis are linked into HIV care within a year, the National AIDS Treatment Advocacy Project reports. Publishing their findings in the journal Sexually Transmitted Diseases, researchers conducted a retrospective study of 6,684 Medicaid patients between the ages of 18 and 64 who were diagnosed with the virus between 2003 and 2010. The study sample had a mean age of 35 years and was 70 percent female and 47 percent African-American.

Defining linkage to care as the receipt of a CD4 and viral load test as per U.S. treatment guidelines, the study found that 21 percent of the group was linked within one year and 26.4 percent within five years. Contrasting previous findings that have showed whites are more likely to be linked to care, the study found that blacks had a significantly shorter lapse between diagnosis and linkage.

The study authors write that their findings suggest “a need for more effective interventions promoting timely linkage to appropriate care after diagnosis.”

To read the study, click here.