Late HIV Diagnosis: Predictors, Costs, Consequences, And Solutions‪.‬

More than a million people in the United States have HIV infection, and fewer than 1 in 5 has an undetectable viral load. (1) That eye-popping estimate--based on a synthesis of recently published data--explains why HIV incidence stands at a staggering 56,000 yearly in the United States, and has since the turn of the millennium. (2) You don't have to look far for the reasons behind these galling tallies: A perdurably high proportion of HIV-positive people remains untested; those who test positive sometimes never see the inside of an HIV clinic; and those who enter care drift away in waves. This triple threat to steady treatment--late diagnosis, sluggish linkage to care, and fleeting retention---conspire to keep the collective viral load so high that further HIV transmission is a foregone conclusion.