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For adults with HIV, lack of viral suppression linked to lower care engagement and increased barriers to care

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More than one-third of HIV adults in the United States are not suppressed by the virus.People who are not suppressed by the virus report less involvement in HIV care and more barriers to care, a September / October study reports. Journal of the Association of Nurses in AIDS Care (((JANAC).

This study highlights the multifaceted barriers to care faced by people living with HIV. Viral load It is under control, according to a new study by colleagues at Sharoda Dasgupta, Ph.D., MPH, and the US Centers for Disease Control and Prevention (CDC). “These findings underscore the importance of addressing barriers to care, especially among those who are not suppressed by the virus.”

New discoveries about barriers to effective care to control HIV viral load

Researchers Health care Approximately 12,000 US adults diagnosed with HIV between 2015 and 2018, drawn from the CDC’s ongoing medical monitoring project. We compared their involvement in care with and without sustained virus suppression. This is defined as all viral load tests being “undetectable” or less than 200 copies per milliliter over the past year. Ensuring that HIV-infected persons reach and sustain virus suppression is an important goal of national strategy, helping to maintain the health of HIV-infected persons and prevent HIV infection.

Overall, nearly 80% of adults diagnosed with HIV remained in HIV care during the study. People without virus suppression were less likely to stay in care, about 57% compared to more than 90% of people with persistent virus suppression. They were likely to miss a healthcare visit or get professional help to get more care. People without persistent virus suppression were also more likely to feel that they were not receiving adequate HIV care: 18% compared to 6% of people with recommended virus suppression.

Almost everyone infected with HIV reported at least one barrier To get HIV care while most report multiple barriers. Living conditions that prevented access to care were reported by half of HIV-infected people.About one-third are money and insurance issues, feeling sick enough to take medicine, and Health provider No further appointments are requested. More than a quarter say they are having a hard time finding transportation as a barrier to getting care.

People who were not suppressed by the virus were more likely to report multiple barriers. They do not believe that living conditions that prevent them from receiving care, money or health insurance issues, fear or denial of living with HIV, or that HIV treatment improves health as a barrier to receiving HIV care. I tended to report.

“Involvement in HIV care is an important predictor of virus suppression and an important outcome in ending the HIV epidemic in the United States,” wrote Dr. Dasgupta and co-authors. Their study is the first to provide detailed, nationally representative estimates of the barriers to HIV care due to viral suppression status in HIV-infected US adults.

This result suggests that many US adults living with HIV have persistent virus suppression and are at risk for HIV-related complications and viral infections. People who are not suppressed by the virus are less likely to engage in care, are more likely to miss a visit, and are more likely to feel that they are not receiving adequate HIV care.

The study also provides insights into complex barriers to HIV care, especially among people with persistent virus suppression. People who are not suppressed by the virus may have unique challenges that prevent them from engaging in HIV care, demonstrating the need for an approach to address barriers to their involvement in care. Wrap Around Services — Often provide HIV-assisted care services to help maintain care, Virus suppression— Essential for HIV patients who may be experiencing a living environment that interferes with their involvement in HIV care, such as substance use, mental health problems, poverty, and the homeless.

Auxiliary care services such as transportation assistance, meal and dietary services, and shelter and housing assistance pose financial barriers to care involvement that were particularly prominent among people not suppressed by the virus. It may help you to deal with it. In addition, the CDC’s “Stay Connected” care retention program is an intervention focused on building relationships between HIV-infected people and healthcare providers (including patient navigators) to address the challenges of engaging in care. is. Building these relationships can help provide referrals to key support services based on the needs of individual patients.

Dr. Dasgupta and colleagues address care barriers through high-impact programs and are experiencing multiple barriers to care, especially through ongoing efforts to leverage a comprehensive care model in the HIV care environment. We conclude that the clinical outcome of HIV may be improved.


CDC: New HIV infection from people who are unaware of the infection


For more information:
Sharoda Dasgupta et al, HIV Care Barriers Due to Viral Suppression in HIV Adults in the United States, Journal of the Association of Nurses in AIDS Care (2021). DOI: 10.1097 / JNC.0000000000000249

Quote: For adults with HIV, lack of viral suppression is associated with reduced involvement in care and increased barriers to care (August 18, 2021), August 18, 2021 https: / Obtained from /medicalxpress.com/news/2021-08-adults-hiv-lack. -viral-suppression.html

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