Related Experiment Video
Updated: Feb 26, 2026
Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
Published on: October 31, 2010
The HIV continuum of care in the Bahamas in 2014
Nikkiah Forbes1, Glenise Johnson1, Arvis Mortimer1
1Bahamas Ministry of Health, Nassau, Bahamas.
Insights
Developing a baseline HIV cascade of care in the Bahamas revealed low retention rates. Enhancing linkage to care and antiretroviral therapy adherence is crucial for improving viral suppression outcomes for people with HIV.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- The HIV cascade of care tracks patient engagement from diagnosis to viral suppression.
- Understanding this cascade is vital for optimizing HIV treatment strategies.
Purpose of the Study:
- To establish a baseline HIV cascade of care for individuals newly diagnosed with HIV in the Bahamas in 2014.
- To identify key points for intervention within the care continuum.
Main Methods:
- A cohort of 250 individuals newly diagnosed with HIV in 2014 was analyzed.
- Linkage to care was defined by one CD4 or viral load (VL) measure; retention by at least two CD4 counts.
- Viral suppression (VS) was defined as VL < 1,000 copies/mL.
Main Results:
- Only 32% of individuals were retained in care within a year of diagnosis.
- Antiretroviral therapy (ART) was prescribed to 46% of the cohort, with 41% of those achieving VS.
- No statistically significant differences in VS were observed between genders or age groups.
Conclusions:
- Significant improvements in linking to and retaining individuals in HIV care are needed in the Bahamas.
- Scaling up ART and implementing adherence interventions are essential to improve viral suppression rates.
Objective:
The HIV cascade of care describes the spectrum of engagement in HIV care from diagnosis to viral suppression (VS). The study objective was to develop a baseline HIV cascade of care for new HIV diagnoses in the Bahamas in 2014.
Methods:
Individuals who were newly diagnosed with HIV in 2014 and known to be alive within a year of that diagnosis were included in the cascade of care (n = 250). Individuals with one CD4 or HIV viral load (VL) measure in 2014 were considered linked to care. Those with at least two CD4 counts in the year were considered retained in care. Eligibility for antiretroviral therapy (ART) was based on having a CD4 count < 350 cells/mm3. ART adherence was defined as filled prescriptions > 11 months/year. VL < 1 000 copies/ml was considered suppressed. Comparisons were made in the cascades by gender and age.
Results:
Of the 250 persons in the study, 79 of them (32%) were retained in care. Antiretrovirals (ARVs) were prescribed to 116 of the 250 (46%); of those 116, 48 of them (41%) achieved VS. A higher proportion of women achieved VS than did men, but this difference did not reach statistical significance. Similarly, there were differences in VS based on age, but the differences were not statistically significant.
Conclusions:
In the Bahamas, increased efforts are needed to help people living with HIV to link to and be retained in care. VS may remain suboptimal unless ART is scaled up and adherence interventions are included in measures to improve the treatment cascade.
Related Concept Videos
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
01:10Retrovirus Life Cycles
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:19Restorative Care
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:21Tertiary Healthcare System