The Centers for Disease Control and Prevention (CDC) may have overestimated the size of the U.S. HIV population while greatly underestimating the proportion that has a fully suppressed viral load. Publishing their findings in the Journal of Acquired Immune Deficiency Syndromes, researchers used HIV laboratory reporting to estimate HIV prevalence in New York City and 19 other jurisdictions and then used previously published data to construct a revised HIV treatment cascade.
The treatment cascade, also known as the HIV care continuum, refers to the descending proportion of people living with HIV who have been diagnosed, are retained in medical care, have been prescribed antiretrovirals (ARVs) and are virally suppressed.
The CDC has estimated that 1.2 million Americans were living with HIV in 2011. The U.S. care continuum estimate, which also refers to 2011, has long stated that 86 percent of the American HIV population has been diagnosed, 40 percent is engaged in care, 37 percent has been prescribed ARVs and 30 percent is virally suppressed. These figures are frequently cited as troublesome barometers of the dismal job the U.S. health care system is doing taking care of HIV-positive individuals.
Recent research has suggested that viral suppression rates have been steadily
increasing among Americans living with the virus.
The researchers in this new study estimated that, in fact, the CDC’s HIV prevalence estimate for 2011 was 25.6 percent too high, that the true number of Americans living with the virus was 819,200, or somewhere between 809,800 and 828,800. Their revised care continuum, also concerning 2011 figures, estimates that 86 percent of the HIV population has been diagnosed, 72 percent is retained in care, 68 percent is on ARVs and 55 percent is virally suppressed.
To read the study abstract, click here.