Ongoing adherence to a prescribed regimen is essential for maintaining viral suppression.1 Maintaining viral suppression can help decrease HIV-associated complications; viral suppression is second only to CD4 cell count as a predictor of disease progression.2 Additionally, as long as a patient achieves and maintains an undetectable viral load, sexual transmission of HIV to an uninfected partner can be prevented.1

Many patients living with HIV are not retained in care; therefore, they are not being virologically suppressed. HIV testing, linkage to care, initiation of effective antiretroviral therapy (ART), adherence to treatment, and retention in care is often referred to as the HIV Treatment Continuum.1

Patients with problems adhering to ART should be prescribed regimens with high genetic barriers to resistance1 . Resistance to a drug not only makes it not effective in treating their HIV, but it can lead to cross-resistance to the entire class of HIV medication.3

Strict adherence is key to reduce the risk of drug resistance1

Image for Strict adherence

Assess medication adherence at every visit, and address as needed to ensure patients are taking ART appropriately.1

The Importance of the HIV TREATMENT Continuum1,4*

Of all patients living with HIV, nearly two-thirds are receiving care, yet only about half are virally suppressed.4

Out of 1.1 million living with HIV

Graph showing percentage of people living with HIV that are receiving care

*Source: 2014 data from the US Centers for Disease Control and Prevention. Numbers and percentages are estimates.

UNAIDS creates a Global movement aiming to increase HIV diagnosis, treatment retention, and suppression by 20205

Challenges remain for getting patients diagnosed and maintaining an undetectable viral load.4 The 90-90-90 goals were created to help communities work together to help stop the HIV epidemic.5 This initiative was created in 2014 and is pioneered by the Joint United Nations Programme on HIV/AIDS (UNAIDS).

  • 2020 GOAL1,5,6


  • 90%

    of people with HIV will be diagnosed

    Provide annual testing for patients with risk factors. The CDC recommends that everyone between the ages of 13 and 64 be tested for HIV at least once as part of their routine healthcare.

  • 90%

    of people diagnosed will be on treatment

    DHHS Guidelines recommend initiating treatment as soon as possible after diagnosis.

  • 90%

    of people on treatment will be virally suppressed

    Establishing clear goals for each visit you have with patients— including the baseline evaluation—is an important component of care.

I like to make sure that that clinical history, not just on the medications, but are you feeling too sick to take your medications right now, how can we help optimize your health so that you are in a place where you can not only start taking the medications but remain adherent to the therapy?"

–Cynthia Rivera, MD

Watch advice on navigating social, clinical, and individual treatment barriers.


  1. US Department of Health and Human Services. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents living with HIV. Updated May 30, 2018. Accessed June 4, 2018.
  2. US Department of Health and Human Services. Health Resources and Services Administration. Guide for HIV/AIDS Clinical Care—2014 Edition. Rockville, MD: US Department of Health and Human Services; 2014.
  3. US Department of Health and Human Services. Drug resistance. Accessed June 11, 2018.
  4. Centers for Disease Control and Prevention. HIV continuum of care, U.S., 2014, overall and by age, race/ethnicity, transmission route and sex. Accessed April 30, 2018.
  5. UNAIDS. 90-90-90: An ambitious treatment target to help end the AIDS epidemic. Accessed June 8, 2018.
  6. Centers for Disease Control and Prevention. HIV testing. Accessed May 31, 2018.