Care and viral suppression during the last year of life among persons with HIV who died in 2012, 18 US jurisdictions.

Death due to HIV remains a leading cause of death among some US populations, yet little is known about HIV care before death. We used data from the National HIV Surveillance System to determine disease stage and care within 12 months prior to death among persons infected with HIV who died in 2012. Persons were considered to be in care within 12 months before death if they had ≥1 CD4 or viral load test results, and in continuous care if they had ≥2 CD4 or viral load test results at least 3 months apart. Viral suppression (viral load <200 copies/mL) was based on the most recent viral load test result in the 12 months before death. Among 7348 persons infected with HIV who died in 2012, 47.1% had late stage disease (AIDS) within 12 months before death. Overall, 85.7% had ≥1 test result, 64.3% had ≥2 tests at least 3 months apart, and 41.6% had a suppressed viral load. While blacks and Hispanics/Latinos had higher percentages of continuous care compared with whites, they had lower percentages of viral suppression and higher percentages with late stage disease. Viral suppression was higher among older persons. The majority had been diagnosed with HIV more than 5 years before death (86.3%). Although the majority of persons infected with HIV who died in 2012 had been diagnosed many years before death, almost half had late stage disease, and there were disparities in late stage disease and viral suppression by race/ethnicity and age.