The care continuum for people living with HIV in Georgia: How can we raise the bar?

Abstract

Background: Viral suppression (VS) improves quality of life and longevity for people living with HIV (PLWH) and reduces viral transmission, but is achieved by only a minority of PLWH in Georgia Methods: By use of the Georgia HIV/AIDS surveillance database, the HIV Care Continuum was stratified by age. Results: Retention in care and VS generally increased with increasing age, with the exception of adolescents (aged 13-18 years), who had the highest retention and VS. Differences by sex, race and transmission category persisted across age groups. Among persons retained in care, the proportion achieving VS also generally increased with age. Linkage to care within 3 months of HIV diagnosis was lower among young adults (aged 19-24 years) (54%); young Black, non-Hispanic (NH) males (49%); and young Black NH men who have sex with men (MSM) (49%) as compared to those among adolescents (66%, 58%, and 57%). Conclusions: Retention in care and VS decreases with the transition from adolescence to young adulthood, possibly reflecting loss of support systems and competing priorities. At the other end of the age spectrum, health care and social support systems will be confronted with increasing numbers of older PLWH in Georgia. Challenges in HIV treatment and prevention include (a) the need for integrated medical care for aging PLWH with co-morbid conditions, and (b) the changing social environment of young PLWH.