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Chances of becoming undetectable today (and the HIV care continuum)
Nov 29, 2017

What are the chances a new patient can become undetectable today in the usa? I was reading that it is only 40%, is that true?

Response from Dr. Young

Hello and thanks for posting.

The chances of a person living with HIV starting treatment and attaining an undetectable viral load is very high. Today's HIV treatments are both highly effective and very well tolerated. Indeed, in our large clinic in Denver, virologic failure has become an exceptionally rare thing; among my hundreds of patients in care, 98% have viral suppression.

The larger issue is getting people tested, linked and retained in care (which in the US also requires maintenence of one's health insurance).

The issue you raise isn't about a 40% success rate in the individual, but rather about the state of our national HIV care continuum- the ecological view that takes all people living with HIV, diagnosed or not, in care or not, or on treatment or not and asks what percentage of the total population have achieve viral suppression. The appreciation of the care continuum is central to the global HIV response and UNAIDS 90-90-90 targets, wherein the goals are by the end of 2020 to have 90% of the all people living with HIV aware of their diagnosis, 90% of those diagnosed on antiretroviral treatment, and 90% of treated people with viral suppression: a overall community viral suppression rate of 73%. Achieving this makes new cases of AIDS a rare event and improves the lives of communities. Several countries (including the UK, Denmark, Sweden, Botswana and Cambodia) and several cities of the UNAIDS/IAPAC/Paris Fast Track Cities Initiative (including New York, London, Amsterdam and Melbourne) have reached (or exceeded) the 90-90-90 targets. Reaching these targets demonstrates that committed governments and communities can bring an end to epidemics. There remains much work to do; including in the US, especially for marginalized communities of people to achieve the end of epidemic AIDS and working towards global health equity, but these magnificent early successes should give us all the courage to demand that other communities, and nations achieve the same. By the end of 2020.

Be well, BY


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