The HIV treatment cascade — also known as the HIV care continuum — is a system used to gauge the number of people living with HIV and how or if these individuals are receiving the care they need. It recognizes the various stages a person goes through in HIV care from initial diagnosis through viral suppression, which is the ultimate goal of HIV care. People vulnerable to HIV often face many structural barriers that prevent them from achieving each step in the process.
The cascade above begins with the number of people in Illinois who have taken an HIV test and have been diagnosed with the virus. It is important to note that the Illinois Department of Public Health estimates that 14% of people living with HIV do not know they have it; AFC estimates that 43,500 people are living with HIV in Illinois total. Stigma and lack of access to medical care often prevent people from getting tested.
What it means: A person has taken an HIV test, and it has detected the antibodies their body has made against HIV, which means HIV is present in their body, and the results of the test have been confirmed and reported to IDPH.
Why it matters: An HIV diagnosis is the first step in helping that person get linked to an HIV specialist or physician who can help them live with HIV. Plus, a person who knows they are HIV-positive is less likely to engage in behaviors that might spread the virus to others.
What it means: Once someone receives a positive HIV diagnosis, it is important to connect them to an HIV health care provider (preferably within three months following diagnosis) and make a health care plan, which includes treatment and prevention counseling.
Why it matters: After receiving a positive HIV diagnosis, individuals may hesitate to contact a provider because of fear, anxiety, stigma, confidentiality concerns, worries about cost or previous disappointing experiences with the health care system. Many HIV testing programs offer “linkage to care” services to help newly diagnosed individuals connect with the care they need. Medical evidence shows that getting treatment and care as soon as possible will help individuals living with HIV stay as healthy as possible and prevent passing HIV to others.
What it means: A person living with HIV had at least one HIV-related medical care visit within a given year and received a documented viral load or CD4+ test.
Why it matters: People living with HIV stay healthier and are less likely to transmit HIV when the amount of HIV in their bodies is reduced by HIV medication. Visiting a medical professional for an HIV-related appointment at least yearly helps maintain that balance.
What it means: Viral suppression means a person living with HIV has an undetectable viral load, or an extremely low level of the HIV in their blood. Viral suppression does not mean a person is cured of HIV. However, it does mean the virus is under control, and cannot multiply and destroy the immune system.
Why it matters: While HIV is a lifelong chronic illness, people living with HIV who are adherent to antiretroviral medications can live long, healthy lives when the virus is under control. Viral suppression means a high quality of life for a person living with HIV, and helps maintain a healthy community, because the virus is extremely unlikely to be passed on to others.