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Treat infections rapidly and effectively

Health outcomes for PLHIV/PLHCV greatly depend on how quickly they receive treatment and whether or not they remain engaged in treatment through cure, in the case of HCV, or maintenance, in the case of HIV.

In 2013, the first approved direct-acting antivirals to cure HCV became available, making elimination of HCV a feasible and attainable goal.[1] PLHCV who complete an 8-12-week oral treatment regimen can avoid the complications of long-term and acute HCV, which include cirrhosis, liver cancer, and liver failure. Rapid enrollment and adherence to a treatment program is essential for HCV elimination, and current efforts are focused on achieving a “90-minute test to treat” timeline to prevent cases lost to follow-up. [2]

HIV is a treatable condition that can be managed with adherence to antiretroviral medication therapy and regular visits to an HIV care provider, allowing PLHIV to live long, healthy lives.[3] Consistent HIV medical care leads to improved health outcomes, greater suppression of HIV viral loads, and reduced chances of HIV transmission. Viral load testing is considered the best way to tell if one’s HIV is being managed.[4] The IDOH recommends that PLHIV should see their HIV care provider every three to four months for T-cell (CD4) and viral load testing.[5]

PLHIV and PLHCV may not seek or adhere to medical care for a variety of reasons, including lack of awareness, lack of insurance, and limited provider capacity.[6] Many may also be living with conditions that make access and adherence to treatment challenging, such as poverty, food or housing insecurity, and issues related to mental health and substance use.

Additionally, many populations at the highest risk for HIV and HCV face social stigma that contributes to fear that results in avoidance of seeking treatment. Differentiated, tailored, and culturally appropriate models of care are essential to supporting these populations with early and sustained HIV and HCV treatment.

The objectives and strategies under the Treat pillar are designed to increase HIV and HCV treatment rates in communities by strengthening systems of care, reducing barriers to treatment, and increasing service provider knowledge of HIV and HCV co-infections. By strengthening existing systems of care to provide more holistic, interconnected, and culturally appropriate HIV and HCV treatment services, PLHIV and PLHCV in Indiana can be connected to care more quickly, and remain in care as needed.

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[1] National Alliance of State and Territorial AIDS Directors. (2019). Findings from the Viral Hepatitis Epidemics Assessment. Retrieved from https://www.nastad.org/sites/default/files/resources/docs/nastad_results_from_hepatitis_assessment_08212019.pdf

[2] National Institutes of Health. (2020). Hepatitis C. Retrieved from https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-c

[3] Crouch, P. (n.d). Rapid Hep C, Test, Treat, and Cure! [PowerPoint Presentation]. National Viral Hepatitis Diagnostics Workgroup https://register.gotowebinar.com/recording/6337086252390212619

[4] HIV.gov. (2017). Seeing Your Health Care Provider. Retrieved from https://www.hiv.gov/hivbasics/

staying-in-hiv-care/provider-visits-and-lab-test/seeing-your-health-care-provider

[5] Joint United Nations Programme on HIV/AIDS. (2016). The Need for Routine Viral Load Testing. Retrieved from https://www.unaids.org/sites/default/files/media_asset/JC2845_en.pdf

[6] Indiana Department of Health Division of HIV/STD/Viral Hepatitis. (2019). HIV Disease.

Retrieved from https://www.in.gov/isdh/23722.htm