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What Research is Telling Us About the State of HIV/AIDS in the United States: Interview with Expert Michael Horberg, MD

Michael Horberg, MD
Michael Horberg, MD

Kaiser Permanente recently hosted the 8th Annual HIV/AIDS, Hepatitis, and STI Conference. The event brought together physicians, advanced practice providers, research scientists, and other care providers, offering a constructive atmosphere for exchanging ideas, learning from national experts, and networking with colleagues from across the nation. For insight into the conference, we spoke with Michael Horberg, MD, national director for HIV/AIDS at Kaiser Permanente and member of the Presidential Advisory Council on HIV/AIDS.

 

CTH Blog:
Tell us about the 8th Annual HIV/AIDS, Hepatitis, and STI Conference you recently hosted.

Michael Horberg:
The goal of the conference has always been to bring together physicians, nurses, pharmacists, allied health professionals, and researchers to determine the latest knowledge and best practices in HIV/AIDS and hepatitis. We want to gather all of the people involved in HIV/AIDS care and share our best knowledge and practices.

The idea is to promote the key areas of learning in these fields: new knowledge and new medications for hepatitis; how to care for lesbian, gay, bisexual, and transgender patients; and new aspects of quality HIV, hepatitis, and sexually transmitted diseases care. Most importantly, we wanted to continue developing the Kaiser Permanente community of committed HIV and hepatitis care teams and community providers.

CTH Blog:
You presented a research study at the conference on the “HIV Engagement Cascade,” with participation of many of the HIV clinical and research leaders in Kaiser Permanente.  I understand this was presented earlier this year at the very important Conference on Retroviruses and Opportunistic Infections.  Can you give us some background for those unfamiliar with that concept?

MH:

For a while now, we’ve known that antiretroviral therapy (ART) can significantly improve health outcomes for people living with HIV. We consider ART to be successful when it reduces the viral load of a person living with HIV to undetectable levels. For years, clinical research has shown that people who have undetectable viral load in their blood are more likely to live long and healthy lives and are less likely to pass the virus on to others.

The CDC developed a standardized care order for how HIV care proceeds from diagnosis to ART success. It’s a series of steps or an engagement “cascade”:

1)    HIV diagnosis
2)    Linkage to HIV care
3)    Retention in care after diagnosis
4)    Prescription of ART
5)    Reaching an undetectable viral load

Each of these steps presents a challenge to an HIV-positive person and to the health workers who try to guide them through consistent care. One particular challenge for HIV-positive individuals is

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