"One of the most interesting things to emerge in the last few years is this new concept of a care continuum or the cascade of care. What that shows is that we lose people from our health care system at multiple steps, multiple levels. We start out with about 20% of the U.S. population who we think have HIV, but they don't know it. Then we [have] the group of patients that are actually tested and they know their HIV status. [Then] we have a drop-off that is significant, in terms of engagement in care.
"Getting people who are HIV infected and known to be HIV infected into care is our first challenge, because we have a lot of treatments that are very effective, but if you're not in care, you can't get them.
"I think getting people into care efficiently and effectively is a huge challenge. I hope we will begin to see monitoring of that, because right now we don't really always know how many people are not linked to care.
"As we monitor that, I think we can begin to measure how well we do at getting people in care and then once they are linked to care, they have to stay in care to have effective antiretroviral therapy -- in terms of individual benefit -- and also to benefit society, in terms of HIV prevention."
-- Melanie Thompson, M.D., Founder and Principal Investigator, AIDS Research Consortium of Atlanta, Atlanta, Ga.