Education Packet

HIV Care Continuum – This packet is a compilation of recent fact sheets and other resources. You may wish to customize it to meet the needs or interests of particular groups, such as event participants, providers, patients, clients, or the general public. So please feel free to distribute all or part of this packet as either a printout or PDF.   

Fact Sheets

HIV Care Continuum (HIV.gov) – This fact sheet answers frequently asked questions about the HIV care continuum, including what it is, why it is considered important, what it shows, and how it is being used.

Understanding the HIV Care Continuum (CDC) – This fact sheet provides an overview of what the HIV care continuum is, the differences between prevalence-based and diagnosis-based continuums of care, the steps in the HIV care continuum, how these steps are measured, and approaches for improving the outcomes at every step of the continuum.

HIV Continuum of Care (Clinicalinfo.HIV.gov) – This glossary entry and associated infographic traces six steps along the HIV care continuum with the goal of reaching and maintaining an undetectable viral load. Also available in Spanish.

Retention in Care – This resource examines several topics related to retention in HIV care: factors associated with poor retention in care; barriers patients face to remaining in care; and tips on communicating effectively with patients to help keep them engaged in care.

HIV Care Continuum Infographics

CDC has produced a series of infographics summarizing HIV care continuum data for the U.S. as a whole, as well as for  specific groups by race/ethnicity, gender, age, and risk category. In general, for each group, data are presented for people with diagnosed HIV aged 13 years or older, and include information on the percentages of those people who: 1) have received some HIV care (defined as having received at least one viral load or CD4 test); 2) were retained in HIV care (defined as having received two viral load or CD4 tests at least three months apart in a year); and 3) were virally suppressed (based on their most recent viral load test).

• HIV Care Among People with Diagnosed HIV in 45 States and the District of Columbia – summarizes data for the U.S. as a whole.
• HIV Care Among People with Diagnosed HIV by Race/Ethnicity – includes breakdowns for each of the following groups: American Indian/Alaska Native people; Asian people; Black/African American people; Hispanic/Latino people; Native Hawaiian and Other Pacific Islander people; White people; and multiracial people.
• HIV Care Among People with Diagnosed HIV by Age – includes breakdowns for each of the following age groups: 13 to 24 years; 25 to 34 years; 35 to 44 years; 45 to 54 years; and 55 years and older.
• HIV Care Among People with Diagnosed HIV by Gender – although there is no single infographic presenting data for different genders, separate graphics are available for men (based on sex assigned at birth), women (based on sex assigned at birth), and transgender men and women.
• HIV Care Among People with Diagnosed HIV Who Inject Drugs (PWID) – includes breakdowns for gay and bisexual men who inject drugs; other men who inject drugs; and women who inject drugs.
• HIV Care Among All Gay and Bisexual Men with HIV – separate infographics also provide care data for Black/African American Gay and Bisexual Men with HIV and Hispanic/Latino Gay and Bisexual Men with HIV.

Reports, Toolkits, and Other Resources

The National HIV/AIDS Strategy (NHAS) for the United States: 2022-2025 (White House, December 2021) – This 98-page document outlines the framework and direction for the Administration’s policies, research, programs, and planning through 2025 in an effort to end the U.S. HIV epidemic by 2030. To evaluate progress toward its goals and objectives, the NHAS establishes a series of indicators including knowledge of HIV status, rates of linkage to care, and viral suppression.

Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data United States and 6 Dependent Areas, 2020 (CDC) – This report presents the results of focused analyses of U.S. HIV surveillance data to measure progress toward ending the HIV epidemic. It includes information on the stage of HIV disease at time of diagnosis, linkage to HIV medical care, viral suppression, prevalence-based HIV care continuum, HIV deaths and survival, use of pre-exposure prophylaxis, and perinatal HIV infections.

Social Determinants of Health Among Adults with Diagnosed HIV Infection, 2019 (CDC) – This surveillance report examines the relationship of social determinants of health (SDH) and steps on the HIV care continuum in the United States. SDH studied include federal poverty level status, education status, income level, health insurance coverage rates, and income inequality. The report also includes a the Special Focus Profiles section that focuses on three factors that merit special consideration when addressing and reducing SDH-related health disparities: residential racial segregation, medical treatment, and psychosocial stress.

Selected National HIV Prevention and Care Outcomes in the United States (CDC) – This fact sheet summarizes recent outcomes for four national indicators specifically related to the HIV care continuum: knowledge of HIV serostatus (diagnosed HIV infection); linkage to HIV medical care; retention in HIV medical care; and viral suppression. Breakdowns for these indicators by gender are also provided.

Prevention IS Care (CDC) – This toolkit, developed as part of CDC’s Act Against AIDS initiative, is designed to help HIV care providers engage patients in care and transmission prevention. It includes materials that can be used to aid patients in understanding the importance of remaining in care, taking ART as prescribed, and practicing safer sexual behaviors to prevent acquisition of sexually transmitted diseases (STDs) and prevent transmission.

Using Community Health Workers to Improve Linkage and Retention in Care (Boston University School of Public Health and other organizations) – This set of resources, available on the TargetHIV website, was developed to help clinics integrate community health workers into an HIV multidisciplinary team model. It includes:

• A Guide to Implementing a Community Health Worker Program in the Context of HIV Care (implementation guide)
• The Community Health Worker Role on the HIV Care Continuum (fact sheet)
• Using Community Health Workers to Improve Linkage and Retention in HIV Care (slide set)
• Improving Linkage and Retention in HIV Care: Insights from Community Health Workers (slide set)
• Improving Linkage and Retention in HIV Care: Lessons from Implementing a Community Health Worker Program in HIV Care (slide set)
  
   

HIV Care Continuum Data for the New England States

AIDSVu Local Data – This resource includes extensive state and county-level HIV data for individual states, including data on the HIV care continuum. The care continuum data, when available, are presented in bar graph format, and are accessible from an “HIV Care Continuum” navigation button that appears directly under the AIDSVu map of each state. For your convenience, we are linking to each AIDSVu state report here: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont. 

Connecticut, Massachusetts, and Rhode Island also have recent HIV care continuum data and reports posted on their state’s health department websites. These include:

HIV Continuum of Care, Connecticut, 2020 – These are annotated bar graphs summarizing data on the care continuum in the state. Information is also presented on how quickly persons are linked to care after their HIV diagnosis.

Massachusetts HIV/AIDS Epidemiologic Profile Statewide Report: Data as of 1/1/2022 – Figures 25 through 33 of this report summarize continuum of care data for Massachusetts for the years 2019 and 2020, with breakdowns by sex assigned at birth, race/ethnicity, age at diagnosis, and primary mode of exposure.

Rhode Island HIV, Sexually Transmitted Diseases, Viral Hepatitis, and Tuberculosis Surveillance Report, 2020. Page 6 of this report summarizes HIV care continuum data for Rhode Island in 2020.

Selected Resources from AIDS Education and Training Centers (AETCs) and HRSA

HIV Care Continuum: Key Resources for HIV Clinicians (AETC National Coordinating Resource Center and National Clinician Consultation Center, December 2022) – This is a compilation of key resources for each stage of the HIV care continuum, including HIV testing and diagnosis, linkage to care, retention in care, and antiretroviral therapy and viral suppression.

HIV Primary Care Update (New England AETC, September 2022) – This webinar covers important emerging areas of HIV medicine including primary care screening, behavioral prevention, PrEP, antiretroviral therapy, the HIV care continuum, cultural competence, and stigma and discrimination.

IAS Update 2022 (New England AETC, August 2022) – This webinar summarizes significant findings and key updates from the 24th International AIDS Conference. Topics include: behavioral prevention, PrEP, antiretroviral therapy, the HIV care continuum, and viral hepatitis.

HIV Screening and Linkage (South Central AETC, April 2022) – These training slides identify why routine HIV screening is a best practice, review how to correctly interpret HIV screening and monitoring tests, and explain status neutral linkage to care.

Evidence-Informed Interventions for Women of Color with HIV (Special Projects of National Significance Models of Care and others, October 2021) – This resource includes enhanced tools for patient navigation and for peer linkage and re-engagement into HIV care.

Recovery Support Services Along the Continuum of Substance Use and HIV Treatment (Pacific AETC, September 2021) – This online course is designed to help participants understand the Recovery Support Services available for people with HIV and co-occurring substance use disorders. This training offers information and interactive activities to help integrate effective recovery support services at different stages along a continuum of care to improve patient retention and engagement.

Leveraging mHealth, Telehealth, and At-home Testing in Rural Areas: Implications for the HIV Care Continuum (South Central AETC and others, September 2021) – These training slides cover health inequities related to accessing culturally competent medical care, and discuss the role of rurality, and cultural norms on primary, secondary, and tertiary HIV prevention interventions.

The Intersection of HIV and Mental Health: Addressing Anxiety, Depression and Suicide Prevention (Pacific AETC, June 2021) – The purpose of this resource is to increase knowledge about the role of mental health in treatment adherence and retention in care, and to offer strategies and tools for people with HIV and mental health issues.

The contents listed on this page are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, the New England AIDS Education and Training Center.