HIV Care Continuum (Treatment Cascade)
Updated February 2017
The care continuum, sometimes referred to as treatment cascade, is a calculation of how many Minnesotans diagnosed with HIV are initially linked to care, retained in care (i.e., receiving medical care for HIV at least one year after diagnosis), and achieve viral suppression. It is an important tool in measuring the successes of the national HIV/AIDS strategy in Minnesota.
The CDC provided guidance on how to make this calculation, but we modified it based on input from HIV prevention and care providers in Minnesota. It was discovered that health care providers in Minnesota typically only do one lab test per year for patients whose HIV infection is well managed instead of two lab tests that the CDC calculation used. With this modification, we were able to get a better sense of HIV care in Minnesota.
It's important to remember that this data is a point in time and not cumulative. It is a snap shot of how HIV positive persons' clinical care occurred in a given year. This year was the first year we were able to add in an estimate of persons living with HIV in Minnesota who were unaware of their status and/or undiagnosed. We have been calculating the care continuum since 2013. Below is the summary of the 2015 care continuum for people diagnosed through 2014.
Percentages of persons with HIV engaged in selected stages of the continuum of care
aDefined as persons undiagnosed (estimate 1,100 [640-1,500], 95% CI) and persons diagnosed (n=7,739) aged 13 or more with HIV infection, regardless of stage at diagnosis, through year-end 2014 and who were alive at year-end 2015.
bDefined as persons diagnosed aged 13 or more with HIV infection, regardless of stage at diagnosis, through year-end 2014 who were alive at year-end 2015.
cCalculated as the percentage of persons linked to care within 30 and 90 days after initial HIV diagnosis during 2014. Linkage to care is based on the number of persons diagnosed during 2014 and is therefore shown in a different color than the other bars with a different denominator.
dCalculated as the percentage of persons who had ≥1 CD4 or viral load test results during 2015 among those diagnosed with HIV through year-end 2014 and alive at year end 2015.
eCalculated as the percentage of persons who had suppressed viral load (≤200 copies/mL) at most recent test during 2015, among those diagnosed with HIV through year-end 2014 and alive at year end 2015.
†Calculated as number of persons who had suppressed VL (≤200 copies/mL) at most recent test during 2015, among those who were retained in care during 2015 (4,801/5,435).