Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: May 26, 2023
Date Accepted: Dec 16, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Progress Towards HIV Care Continuum Goals: Results from 36 AIDSVu Cities
ABSTRACT
Background:
Public health surveillance data are critical to understanding the current state of the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) epidemic. Surveillance data provide significant insight into patterns within and progress towards achieving targets for each of the steps in the HIV care continuum. If these data are disseminated, they can be used to prioritize certain steps in the continuum, locations, and/or groups of people.
Objective:
We sought to develop and report indicators of progress towards the National HIV/AIDS Strategy (NHAS) goals for U.S. cities and to characterize progress towards those goals with categorical metrics.
Methods:
Health departments used standardized SAS code to calculate care continuum indicators (late diagnosis, linkage to medical care, receipt of medical care, and HIV viral load suppression) from National HIV Surveillance System data to ensure comparability across jurisdictions. We report 2018 descriptive statistics for continuum steps for 36 U.S. cities and their progress towards 2020 National HIV/AIDS Strategy (NHAS) goals as of 2018. Indicators are reported categorically as met or surpassed the goal (green), within 25% of attaining the goal (yellow), or further than 25% from achieving the goal (red).
Results:
Cities were closest to meeting NHAS goals for timely diagnoses, with all cities (100%) within 25 percentage points of meeting the goal. Only 8% of cities were >25% from achieving the goal for receipt of care, but 69% of cities were >25% from achieving the goal for viral suppression.
Conclusions:
Evaluation involving common analytic methods enables unbiased comparisons of the HIV care continuum across cities. Display of progress with graphical indicators allows communication of progress to stakeholders. AIDSVu analyses of HIV surveillance data facilitate cities’ ability to benchmark their progress against that of other cities with similar characteristics. By identifying peer cities (e.g., cities with analogous populations or similar NHAS goal challenges), the public display of indicators can promote dialogue between cities with comparable challenges and opportunities.
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