In a report presented Friday at the International AIDS Conference in Washington, D.C., researchers from the U.S. Centers for Disease Control and Prevention said the problem applies to patients of all ages, races and ethnic groups, but especially to young people and blacks.
"This is the first time that we have ever looked at the outcome of continuum of care across all patient groups," said CDC epidemiologist Irene Hall. "And what we found is that, overall, too few people with HIV have viral suppression." People with viral load suppression are healthy and less likely to transmit the virus to others.
"Only if we get everyone under regular care for HIV/AIDS can we recognize the full benefits of treatment and prevention," said Hall, chief of the HIV incidence and case surveillance branch in the CDC division of HIV/AIDS prevention.
For the report, Hall and her colleagues pored through 2009 data collected by the CDC, which included rates of HIV testing, patient participation in the health care system, continuity of care for HIV, treatment prescribed, and the patient's viral load status in terms of suppression.
Overall, about 82 percent of all those infected with HIV know their status, meaning that more than 200,000 Americans now infected with HIV are not aware of their condition.
Two-thirds of the nation's HIV patients do have some relationship with a care provider, the report indicates, and more than one-third (37 percent) receive continuous HIV care, while one-third are treated with antiretroviral therapy.
But just over one-third of black patients were found to have ongoing care, compared with 37 percent to 38 percent of Latinos and whites. Similarly, just a little over one in five black patients was found to have viral load suppression, compared with 26 percent of Latinos and 30 percent of whites.
Blacks infected with HIV were the least likely to find out they were infected in the first place and the least likely to get any care for HIV, Hall added.
Younger HIV patients were also much less likely than older patients to know their HIV status and to obtain routine care, Hall said.
Suppression rates were also poorer among younger patients, with just 15 percent of those aged 25 to 34 having their virus under control compared with 36 percent among those aged 55 to 64.
No significant differences were seen between males and females in terms of diagnosis, treatment or disease control.
For now, the report authors can only theorize about what lies behind these differences in HIV care.
"Our study did not look at the reasons for why people are not in care, or are not prescribed
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