D Gregory Smith

CDC Analysis: 4 out of 10 HIV-Diagnosed Not In Care

Filed By D Gregory Smith | August 31, 2011 5:00 PM | comments

Filed in: Living
Tags: HIV/AIDS, HIV/AIDS care, insurance, leaving care, National HIV Guidelines, National HIV/AIDS Strategy, open thread, poverty, race, support groups

An analysis of epidemiological data by the Thumbnail image for Test tubeCenters for Disease Control has arrived at a startling conclusion: as many as 4 out of 10 persons diagnosed with HIV do not remain in care.

Despite all the medical evidence which advocates early HIV treatment for a healthy life, people are still not accessing care. The specific reasons are unclear, but the National HIV Treatment Guidelines are very clear: Persons with HIV are to be tested for viral load and CD4 counts ever 3-4 months, unless they are considered "virus-suppressed" (usually with an undetectable viral load and normal CD4 count with no medication changes over a period of time), then it is every 6-12 months.

So, what's happening?

In surveillance data from 13 regions, only 59% of people recently diagnosed with HIV had had a test for viral load or CD4-positive T-cell count within the previous year, according to Irene Hall, PhD, head of the CDC's HIV incidence and case surveillance branch.

The finding implies that the remaining 41% are not under a physician's continuing care, Hall said in a teleconference during the 2011 National HIV Prevention Conference in Atlanta.

The two tests are a "marker for being in care," Hall told MedPage Today.

Maybe it's time to start talking seriously about barriers to proper care, including discrimination, poverty, cultural issues and race.

At a time when we know treatment is prevention, it's important that the members of our communities who are HIV infected receive the care they need.

I'm wondering if it's about support. Many of the people in my HIV+ support groups help each other with their health care- talking honestly about issues, sharing resources - even giving each other rides to doc or lab visits. They stay on their meds, talk realistically about their health, exercise, pay closer attention to nutrition and reducing stress. They do it because they have people they can speak to honestly about their disease - people who know firsthand what it's like. And, for the most part, they're having incredible, fulfilling lives.

In my experience, it's the people who are trying to deal with HIV on their own who don't do so well.

Depression and fear can play an enormous part in healthcare apathy - and it's a well-documented fact that fear and depression are alleviated by concern and compassion from family and friends - and involvement with others who share similar circumstances.

So, in the interest of trying to understand this better, I have a couple of questions:

Do you know anyone (maybe it's you) with HIV who is not getting care for their disease? What can be done to get them into care?

I'd like to follow up with your responses so feel free to contact me through Bilerico if you are uncomfortable leaving a response in the thread.

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While getting PWHIV into care is totally commendable, I think we need to mention what is a human near-universal: denial.

I expect if you picked any other serious chronic health condition -- cancer, diabetes, cardiovascular disease, hypertension -- the stats between those that have been diagnosed and those receiving menaingful treatment would be about the same. My point being that we are doing about as good a job with HIV as we are with other diseases, no better, no worse. Even so, I commend you, Gregory, for your extra efforts and whenever I see similar efforts throughout the AIDS community.

To answer your question -- The need for mental health services is so unbounded I don't think it could ever be exhausted. Yet mental health professionals and other forms of emotional support can be difficult or impossible to access, especially in rural areas.

Yeah- mental health services are sadly underused when dealing with newly HIV-diagnosed persons...
Thanks for your input!