Testing & link to care

Despite major progress against HIV, 21% of HIV+ people in the US are unaware that they are positive and an estimated 33% of those who know they are HIV+ are not engaged in care and treatment for their infection.Another 38% of newly diagnosed HIV+ individuals test so late that they receive an AIDS diagnosis at the same time as, or within one year of, learning they are positive. There were an estimated 56,300 new HIV infections per year between 1996 and 2006. Clearly, the US can and must do better in responding to the HIV/AIDS epidemic. One way to increase the percentage of HIV+ people engaged in care and treatment for their infection and improve their health outcomes is to focus on coordinating or co-locating HIV testing, care and treatment, social services and prevention programs. Increasing the percentage of HIV+ people who know their serostatus and are receiving care and antiretroviral treatment could also have benefits for HIV prevention. The National HIV/AIDS Strategy places testing and linkage to care, treatment and support services at the heart of the effort to improve the health outcomes of HIV+ individuals and prevent new infections. What is the scientific basis for this approach, how might it actually be implemented, and will it have the desired results in the real world?