Last Updated: October 2022

Author: HIV, AIDS, STD, and Hepatitis Program, Vermont Department of Health

Anti-Retroviral (ARV) therapy, the medications used to treat HIV infection, can significantly improve the health outcomes of people living with HIV (PLWH). ARVs work to reduce viral replication, reducing what is known as “viral load.” A goal for patients on ARVs is to achieve and maintain a viral load that is undetectable.

Research has shown that having an undetectable viral load not only improves the health of PLWH, it also reduces the likelihood of viral transmission to others. This convergence of improved health outcomes and prevention through treatment has turned our attention toward linking PLWH to HIV care after diagnosis.

Linkage to care after diagnosis is an integral part of the HIV Care Continuum, a model for working with people at increased risk for HIV acquisition and transmission. For PLWH to achieve viral suppression, they need access to a continuum of services. The first step is testing and diagnosis. The sooner a person is engaged in care after diagnosis, the better. Following linkage to appropriate medical care, PLWH need access to ARV therapy and support services. These all are important steps on the road to viral suppression.

The HIV Care Continuum is not seamless and some people are lost at each step. Some barriers to linkage to care and retention in treatment include:

• Limited access to services
• Perceived stigma, feelings of shame
• Poverty, homelessness, food insecurity
• Mental health and substance abuse issues
• Lack of knowledge about services and support

Assisting PLWH in overcoming these barriers will increase the number of people engaged at all levels of the Continuum. This will not only improve the health of PLWH, but may also reduce the number new HIV transmissions in Vermont.

This indicator is part of Healthy Vermonters 2020 (the State Health Assessment) that documents the health status of Vermonters at the start of the decade and the population health indicators and goals that will guide the work of public health through 2020. Click here for more information.

AIDS Service Organizations

Community Based Organizations

HIV Counseling, Testing, and Referral providers

Medical providers throughout Vermont

Health Department District Office HIV/AIDS/STD/Hepatitis Program Designees

Syringe Exchange Programs

The Health Department follows up on all newly reported cases of HIV to ensure they are appropriately linked to medical care as well as to support services provided by community based organizations.

The Health Department will continue to monitor new HIV infections and the time between diagnosis and being connected to medical care. The Health Department is committed to ensuring that at least 90% of new cases are connected to medical care within 90 days, and will continue to educate partners of the importance of timely linkage to care.

Data changed/updated in 2019.