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Summary
This summary is machine-generated.

The Veteran Health Administration's HIV Care Continuum saw declines in linkage, care, and retention from 2019 to 2022. Despite this, viral suppression rates remain high, exceeding national averages.

Keywords:
HIVcontinuity of caredelivery of health careepidemic

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Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Healthcare Quality Improvement

Background:

  • The Human Immunodeficiency Virus (HIV) Care Continuum is a vital framework for assessing and improving HIV care quality.
  • It guides national strategies for managing HIV from diagnosis to viral suppression.
  • The Veteran Health Administration (VHA) utilizes this continuum to evaluate its HIV care services.

Purpose of the Study:

  • To present the VHA's HIV Care Continuum performance.
  • To compare prepandemic (2019) and postpandemic (2022) VHA performance.
  • To benchmark VHA's HIV care outcomes against national data from the Centers for Disease Control and Prevention (CDC).

Main Methods:

  • A nationwide retrospective cohort analysis was performed on people with HIV (PWH) within the VHA system.
  • Data from 2019 and 2022 were analyzed, focusing on key continuum metrics: linkage to care, receipt of care, retention in care, and viral suppression.
  • Multivariable logistic regression identified factors associated with viral suppression.

Main Results:

  • In 2019, VHA achieved 83% linkage, 84% receipt of care, 76% retention, and 76% viral suppression (93% with VL results).
  • By 2022, these figures decreased to 74% linkage, 79% receipt of care, 67% retention, and 70% viral suppression (94% with VL results).
  • Overall viral suppression among all PWH declined by 5.2% between 2019 and 2022.

Conclusions:

  • The VHA demonstrates high viral suppression rates (>90%) among individuals with available viral load results.
  • A notable decrease in HIV care continuum metrics, including viral suppression, was observed between 2019 and 2022.
  • VHA's HIV Care Continuum performance surpasses national averages reported by the CDC.