The Centers for Disease Control and Prevention (CDC) has reframed the so-called HIV treatment cascade figures to highlight the various reasons why only 30 percent of HIV-positive Americans have a fully suppressed virus. Publishing their findings in the CDC Morbidity and Mortality Weekly Report (MMWR), researchers analyzed data reported to the National HIV Surveillance System through December 2013, and also looked at data reported to the Medical Monitoring Project between January and April 2011 to estimate various key statistics relating to HIV-positive Americans’ engagement in care and treatment for the virus.

The treatment cascade statistics have not budged much since 2011, when the CDC made estimates about 2008. At that time, an estimated 80 percent of HIV-positive Americans were diagnosed, 62 percent were linked to care, 41 percent were retained in care, 36 percent were on antiretrovirals (ARVs) and 28 percent had a fully suppressed virus. The new report estimates that in 2011 86 percent of people living with HIV were diagnosed.  This report does not make an estimate for linkage to care, but places the remaining figures in the treatment cascade at 40 percent, 37 percent and 30 percent, respectively.

Of the estimated 840,000 HIV-positive Americans who did not have a suppressed virus in 2011, 20 percent were unaware of their infection, 66 percent had been diagnosed but were not engaged in regular HIV care, 4 percent were in care but had not been prescribed ARVs, and 10 percent were on ARVs but did not have a fully suppressed viral load.

Just 13 percent of HIV-positive Americans ages 18 to 24 were estimated to be virally suppressed, compared with 23 percent of those ages 25 to 34, 27 percent of those 35 to 44, 34 percent of those 45 to 54, 36 percent of those 55 to 64, and 37 percent of those older than 65. The researchers believe the reason for this generational disparity is that the young have a very low diagnosis rate: Only 49 percent of HIV-positive Americans between 18 and 24 years old know they are living with the virus.

To read the press release, click here.

To read the MMWR report, click here.