HIV Care Continuum

The HIV Care Continuum: Steps from Diagnosis to Viral Suppression

The HIV continuum is a model that outlines the sequential steps that people living with HIV go through from initial diagnosis to achieving the goal of viral suppression (a very low level of HIV in the body) and shows the proportion of individuals living with HIV who are at each stage.

In 2011, Dr. Edward Gardner and colleagues observed that for persons with HIV to benefit from antiretroviral therapy, they need to know that they are living with HIV, be engaged in regular HIV care, and adhere to antiretroviral therapy. They acknowledged, however, that barriers contribute to poor engagement in HIV care, which limits the effectiveness of efforts to improve health outcomes for those with HIV and to reduce new transmissions. The researchers sought to describe the spectrum of engagement in HIV care. The result of their work was the HIV continuum (or cascade), which they defined as having the following stages:

  1. Diagnosis of HIV infection

  2. Linkage to Care

  3. Retention in Care

  4. Receipt of Antiretroviral Therapy

  5. Achievement of Viral Suppression

Many state and local jurisdictions have used or adapted this HIV continuum to better identify gaps in HIV services and develop strategies to improve engagement in care and outcomes for people living with HIV.


2017 HIV Care Continuum

2018 HIV Care Continuum

2019 HIV Care Continuum