No abstract

Less than half of persons living with HIV had laboratory evidence of ongoing clinical care and only two thirds established care after diagnosis. Further assessments determining modifiable barriers to accessing care could assist with achieving public health targets.

Using data from the National HIV Surveillance System, we determined the number of persons diagnosed with HIV and the percentages of persons linked to care, retained in care, and virally suppressed across 19 jurisdictions with complete reporting of CD4 and viral load test results. Reports from these jurisdictions represent 37% of persons diagnosed with HIV infection in the United States in 2011. Although 80% of persons diagnosed in 2011 were linked to HIV medical care within 3 months of diagnosis, half of all persons living with HIV in the 19 jurisdictions were not receiving ongoing care in 2010. In addition, 43% of persons living with HIV by year-end 2009 and alive at year-end 2010 did not have a suppressed viral load, with substantial variability across the 19 jurisdictions. These data highlight the need for improved outcomes along each step of the HIV continuum of care.

The burden of HIV disease in the United States is monitored by using a comprehensive surveillance system. Data from this system are used at the federal, state, and local levels to plan, implement, and evaluate public health policies and programs. Implementation of HIV reporting has differed by area, and for the first time in early 2013, estimated data on diagnosed HIV infection were available from all 50 states, the District of Columbia, and six U.S. dependent areas. The newly available data for the entire U.S. as well as several other key changes to the surveillance system support the need to provide an updated summary of the status of the National HIV Surveillance System.