Drew, R.S., Rice, B., Ruutel, K., et al. HIV Medicine (2017), 18,490–499, doi: 10.111/hiv.12480.
This report assessed how the HIV continuum of care is measured across 55 European and Central Asian countries. It includes quantitative data from 40 countries; the data most often provided were the number of people diagnosed with HIV and the number of people on antiretroviral treatment (ART). Most countries defined “diagnosed with HIV” as a cumulative number ever diagnosed, without excluding individuals who may have died. Countries defined “linkage to care” in multiple ways, including registration and having specified lab tests or CD4 cell count results. The definition of “retained in care” also varied, including one visit/year and having a visit within one year of enrollment. The definition of “on treatment and undetectable viral load (VL)” most often included the number of individuals ever on ART, or on ART at the end of the year. There was a wide range of VL thresholds, from <20 to <500 copies/mL. Among countries reporting data, cumulative estimates indicated that 76 percent of people living with HIV (PLHIV) are diagnosed, 78 percent of diagnosed PLHIV are on treatment, and 88 percent of PLHIV on treatment are virally suppressed. Globally, however, only 53 percent of all PLHIV are virally suppressed. Countries need to identify standard definitions for each step within the continuum of care to improve planning for HIV testing and treatment programs in Europe and Central Asia.