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Many HIV-Positive People in U.S. Fail to Begin Care or Remain in Care

August 2012

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What the Results Mean for You

This 100,375-person U.S. study found that only 59% of people with a positive HIV test by the end of 2008 and alive at the end of 2009 had at least one HIV care visit within the past 12 months. Only 45% of that group had steady HIV care, defined as having two HIV care visits at least 3 months apart. These low rates mean that a high proportion of people living with HIV were not in steady care for HIV.

HIV-positive people who do not establish and maintain steady care run a high risk that their HIV infection will get worse and a high risk that they will pass their HIV on to sex partners or drug-injecting partners. If you are HIV-positive, it is critically important to begin care for your HIV infection promptly and to keep all HIV care appointments.

The researchers who conducted this study list several factors that may explain why people who test positive do not begin HIV care promptly or do not continue care:

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  • Mental health problems
  • Substance abuse
  • HIV stigma (fear of discrimination because of HIV infection)
  • Lack of health insurance
  • Lower education level
  • Poverty
  • Unemployment
  • Homelessness
  • Lack of transportation

Counselors where you have your HIV test should help you find an HIV provider you can see promptly and regularly. You can also get help finding an HIV provider from local HIV/AIDS organizations or from any other healthcare provider you may see.

Once you have begun care, your HIV provider can direct you to counselors or social workers (sometimes within the provider's office) who can help you address problems that make it difficult to keep appointments at your HIV clinic. These workers can help you work with government and nongovernment programs that deal with many of the problems listed above. Counseling and treatment are available for mental health problems and substance abuse. If you need help with these problems, ask you HIV provider or social worker to recommend services that deal with them.

You should not assume that you can put off HIV care because you feel healthy when you test positive. HIV may not make a person sick for years after infection. But the virus is damaging your health whenever you are not being treated, and it may not be possible to correct some of this damage.

If you start antiretroviral therapy for HIV, your CD4 count will probably go up and your viral load will go down. If you were sick before you started treatment, you will probably feel better as treatment continues. But these improvements do not mean you can stop antiretroviral therapy, and they do not mean you can stop keeping HIV care appointments. Antiretrovirals do not cure HIV infection; you will have HIV infection for the rest of your life. Only steady care and effective antiretroviral treatment can keep your HIV under control.


References

  1. Hall HI, Gray KM, Tang T, Li J, Shouse L, Mermin J. Retention in care of adults and adolescents living with HIV in 13 U.S. areas. J Acquir Immune Defic Syndr. 2012;60:77-82.
  2. HHS Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. March 27, 2012.
  3. Marks G, Gardner LI, Craw J, et al. Entry and retention in medical care among HIV-diagnosed persons: a meta-analysis. AIDS. 2010;24:2665-2678.
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This article was provided by The Center for AIDS Information & Advocacy. It is a part of the publication HIV Treatment ALERTS!. Visit CFA's website to find out more about their activities and publications.
 

 

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