Substance use and the HIV care continuum: important advances

Excerpt

The HIV care continuum identifies five stages of HIV medical care: (1) HIV diagnosis, (2) linkage to HIV care, (3) engagement and retention in HIV care, (4) treatment with antiretroviral therapy (ART), and (5) achievement of HIV viral suppression—all of which are essential to effectively treat and prevent the spread of HIV. Most recent estimates indicate that in the United States, 85% of people living with HIV are diagnosed, 62% are linked to care, and only 49% achieve HIV viral suppression [1]. People who use drugs and alcohol are particularly likely to experience gaps in each stage of the HIV care continuum. While antiretroviral therapy has dramatically improved the life expectancy for people living with HIV, important disparities remain among people with substance use that threaten individual and public health [2]. Screening for and treating substance use may close these gaps in outcomes and help achieve the UNAIDS 90-90-90 goal of 90% diagnosis, 90% ART treatment, and 90% HIV viral suppression by 2020 [3]. …