ArticleJournal of acquired immune deficiency syndromes (1999)2017
A Flow-Based Model of the HIV Care Continuum in the United States.
Article in Journal of acquired immune deficiency syndromes (1999), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Using queueing models as a decision support tool in allocating point-of-care HIV viral load testing machines in Kisumu County, Kenya.Health policy and planning · 2024Article
- Examining the Association Between a Modified Quan-Charlson Comorbidity Index and HIV Viral Suppression: A Cross-Sectional Analysis of DC Cohort Participants.AIDS research and human retroviruses · 2023Article
- A qualitative model of the HIV care continuum in Vancouver, Canada.Health systems (Basingstoke, England) · 2022Article
- Opioid use disorder Cascade of care framework design: A roadmap.Substance abuse · 2022Article
- Substance use and HIV stage at entry into care among people with HIV.Archives of public health = Archives belges de sante publique · 2021Article
- Interprofessional collaboration improves linkages to primary care: a longitudinal analysis.AIDS care · 2020Article
- Limitations of the UNAIDS 90-90-90 metrics: a simulation-based comparison of cross-sectional and longitudinal metrics for the HIV care continuum.AIDS (London, England) · 2020Article
- Optimizing Interventions Across the HIV Care Continuum: A Case Study Using Process Improvement Analysis.Operations research for health care · 2020Article
- Implementation Science to Respond to the COVID-19 Pandemic.Frontiers in public health · 2020Article
- Making Smarter Decisions Faster: Systems Engineering to Improve the Global Public Health Response to HIV.Current HIV/AIDS reports · 2019Review
- Tenofovir Diphosphate in Dried Blood Spots Is Strongly Associated With Viral Suppression in Individuals With Human Immunodeficiency Virus Infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Observational
- Intersectional Stigma and Multi-Level Barriers to HIV Testing Among Foreign-Born Black Men From the Caribbean.Frontiers in public health · 2019Review
- Development of a Cascade of Care for responding to the opioid epidemic.The American journal of drug and alcohol abuse · 2019Article
- Human immunodeficiency virus and liver disease: A comprehensive update.Hepatology communications · 2017Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundUnderstanding the flow of patients through the continuum of HIV care is critical to determine how best to intervene so that the proportion of HIV-infected persons who are on antiretroviral treatment and virally suppressed is as large as possible.
methodsUsing immunological and virological data from the Centers for Disease Control and Prevention and the North American AIDS Cohort Collaboration on Research and Design from 2009 to 2012, we estimated the distribution of time spent in and dropout probability from each stage in the continuum of HIV care. We used these estimates to develop a queueing model for the expected number of patients found in each stage of the cascade.
resultsHIV-infected individuals spend an average of about 3.1 months after HIV diagnosis before being linked to care, or dropping out of that stage of the continuum with a probability of 8%. Those who link to care wait an additional 3.7 months on average before getting their second set of laboratory results (indicating engagement in care) or dropping out of care with probability of almost 6%. Those engaged in care spent an average of almost 1 year before achieving viral suppression on antiretroviral therapy or dropping out with average probability 13%. For patients who achieved viral suppression, the average time suppressed on antiretroviral therapy was an average of 4.5 years.
conclusionsInterventions should be targeted to more rapidly identifying newly infected individuals, and increasing the fraction of those engaged in care that achieves viral suppression.
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