HIV/AIDS Bureau.
Office of the Administrator, Health Resources and Services Administration, Rockville, Maryland.
Clin Infect Dis. 2015 Jan 1;60(1):117-25. doi: 10.1093/cid/ciu722. Epub 2014 Sep 15.
In the human immunodeficiency virus (HIV) care continuum, retention in HIV medical care and viral suppression are key goals to improve individual health outcomes and reduce HIV transmission. National data from clinical providers are lacking.
HIV providers funded by the Ryan White HIV/AIDS Program (RWHAP) annually report demographic, service, and clinical data using encrypted unique client identifiers, and data are processed and de-duplicated to create a single record for each client. We calculated retention and viral suppression for clients who received RWHAP-funded HIV medical care in 2011. We conducted multivariate logistic regression to identify factors associated with these outcomes.
In 2011, an estimated 512 911 HIV-infected clients received at least 1 RWHAP-funded non-AIDS Drug Assistance Program service. Of these, 317 458(61.8%) were seen for at least 1 HIV medical care visit. Of these, 82.2% were retained in HIV medical care, and 72.6% achieved viral suppression. Viral suppression was higher among retained clients (77.7%) vs clients who were not retained (58.3%). The lowest levels of retention and viral suppression were among individuals aged 13-34 years.
The RWHAP provides HIV medical care and support services for more than half a million poor and underinsured individuals living with HIV in the United States. Rates of retention and viral suppression are relatively high compared with other national estimates but demonstrate room for improvement, especially among youth and racial minorities. Additional improvements in retention and viral suppression will contribute to achieving the goals of the National HIV/AIDS Strategy and improve individual and public health.
在人类免疫缺陷病毒（HIV）关怀连续体中，保留在 HIV 医疗保健中并抑制病毒是改善个人健康结果和减少 HIV 传播的关键目标。缺乏来自临床提供者的国家数据。
每年通过 Ryan White HIV/AIDS 计划（RWHAP）资助的 HIV 提供者使用加密的唯一客户端标识符报告人口统计，服务和临床数据，并且数据经过处理和去重复，为每个客户端创建一个唯一记录。我们计算了在 2011 年接受 RWHAP 资助的 HIV 医疗保健的患者的保留率和病毒抑制率。我们进行了多变量逻辑回归分析，以确定与这些结果相关的因素。
2011 年，估计有 512911 名 HIV 感染者接受了至少 1 次 RWHAP 资助的非艾滋病药物援助计划服务。在这些人中，有 317458（61.8％）人至少进行了 1 次 HIV 医疗保健就诊。其中，有 82.2％的人保留在 HIV 医疗保健中，有 72.6％的人实现了病毒抑制。保留的患者中病毒抑制率更高（77.7％），而非保留的患者（58.3％）。保留率和病毒抑制率最低的是 13-34 岁的人群。
RWHAP 为美国超过 50 万患有 HIV 的贫困和保险不足的个人提供 HIV 医疗保健和支持服务。与其他国家的估计相比，保留率和病毒抑制率相对较高，但仍有改进的空间，尤其是在年轻人和少数族裔中。保留率和病毒抑制率的提高将有助于实现国家 HIV/AIDS 战略的目标，并改善个人和公共卫生。
