Review the Scientific Evidence

According to the latest Centers for Disease Control and Prevention (CDC) data, about 1.1 million people in the United States are living with HIV infection; there were an estimated 37,600 new HIV infections in 2014.
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Early initiation of antiretroviral therapy (ART) has been shown to improve health, suppress HIV viral load, and reduce the risk of transmitting HIV to others. Initiating treatment early can also hasten use of behavioral and structural interventions that can reduce the risk of transmitting HIV.²

Patients living with HIV may not be aware that their behaviors can lead to HIV and sexually transmitted disease (STD) transmission or STD acquisition. For example, a recently published MMWR from CDC³ showed that among HIV-infected men who have sex with men (MSM):

• 31.8% engaged in anal intercourse without a condom.
• Nearly 14% had anal sex without a condom with partners who were either HIV-negative or of unknown serostatus.

MSM bear the greatest burden of STDs in the general population.⁴ This is particularly concerning considering that STDs increase the viral load: In one study of HIV-infected men, those with syphilis had an increase in viral load five times that of HIV-infected men without syphilis.⁵ Yet, less than half of all HIV-infected patients received counseling about available HIV and STD prevention strategies.³

CDC recommends² that providers of health care to persons living with HIV integrate routine discussions on ART adherence; safer sexual practices; and regular, ongoing medical care into every office visit as a critical element of care to protect the health of the patient and that of their partners. Through open discussion, health care providers and patients can uncover barriers, identify strategies, and set behavioral goals to effect behavior change. This approach confers several benefits:

• Early initiation of and sustained adherence to ART is needed to consistently suppress viral load, maintain high CD4 cell counts, prevent AIDS, prolong survival, and reduce risk of HIV transmission.^{2, 6}
• Brief discussions have been shown in several recent studies to be helpful to persons living with HIV in modifying their sexual behaviors:
  • Decline in sex without a condom^6–7
  • Fewer sexual partners⁸
  • Decline in STD acquisition.⁹
• Retaining HIV-infected patients in regular, ongoing care has been demonstrated to decrease viral load, increase CD4 cell count, reduce morbidity and mortality, and enhance transmission prevention.^{8, 10}
  • In one study, HIV-infected patients who received ongoing, regularly scheduled care had significantly lower viral loads and higher CD4 cell counts than those who missed even one medical visit over a 2-year period.¹⁰

Based on clinical evidence, and CDC’s 2014 recommendations for HIV prevention with adults and adolescents, Prevention IS Care  helps facilitate small talks between HIV care providers and patients about a variety of topics that affect the health and well-being of HIV infected patients. These include helping patients to remain in ongoing medical care, improving patient adherence to ART, and promoting safer sexual behaviors.

Order or download evidence-based educational brochures and in-practice tools to motivate patients to live longer, healthier lives by remaining in HIV care, adhering to ART, avoiding co-infections and STDs, and reducing HIV transmission to others.

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