Early, life-long treatment can allow a person with HIV to reach near-normal life expectancy. Early treatment also reduces rates of opportunistic infections, non-AIDS related disease and death, which improves quality of life for people living with HIV. Treatment can also substantially reduce the risk of passing HIV to sex partners when a person's viral load is undetectable.,,
Despite the availability of effective treatment, many people living with HIV in Canada are not adequately engaged in care.,, The International Association of Providers in AIDS Care (IAPAC), an international body that represents more than 17,000 clinicians, has developed the first comprehensive, evidence-based guidelines for improving engagement and retention of people living with HIV in the HIV care continuum (also known as the HIV treatment cascade). The aims of the guidelines are to increase HIV testing, linkage to care, treatment, engagement and retention in care, and viral suppression.
The guidelines focus on the clinical, behavioural, social and structural interventions that will improve access to and retention in HIV care. IAPAC's 36 evidence-based recommendations are divided into six categories:
- Optimizing the HIV care environment
- Increasing HIV testing coverage and linkage to care
- Increasing HIV treatment coverage
- Increasing retention in care, HIV treatment adherence, and viral suppression
- Metrics for and monitoring of the HIV care continuum
Frontline service providers, including AIDS service organizations, community health centres and public health units can implement many of the recommendations to better serve their clients. Using the recommendations as a foundation for effective programs and services will help us achieve the global testing and treatment targets set out by UNAIDS in its 90-90-90 strategy. Meeting these targets will allow us to end the spread of HIV by 2030.
IAPAC Guidelines for Optimizing the HIV Care Continuum for Adults and Adolescents
Logan Broeckaert holds a Master's degree in History and is currently a researcher/writer at CATIE. Before joining CATIE, Logan worked on provincial and national research and knowledge exchange projects for the Canadian AIDS Society and the Ontario Public Health Association.
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