Continuum of HIV care of newly diagnosed individuals in Israel, 2011–2015: a population-based cohort study

Abstract

Our aim was to assess the linkage to care (LTC) and treatment for people newly diagnosed with HIV in Israel during 2011–2015. The Ministry of Health estimated the annual prevalence of undiagnosed HIV; new diagnoses were identified by the Central Virology Laboratory. Only adult Israeli citizens were included. LTC at HIV centers within 90 days of diagnosis was assessed. Demographic and clinical data were collected from patient files. A total of 1538 individuals were diagnosed in 2011–2015. A moderate improvement over time was observed in the calculated proportions of undiagnosed individuals (23.1–17.3%) but no change occurred in LTC rates (82.6–81%). The proportion of diagnosed patients initiating treatment within six months increased from 54.7% in 2011 to 89.7% in 2015, with a parallel increase in the viral suppression rate from 30.5% in 2011 to 59.9% in 2015. Of 1159 patients with detailed records, 79.4% were men, median age 36 years (16–92), median CD4 cell count 342 cells/µl. Younger age, intravenous drug use, and imprisonment were independent risk factors for loss to follow-up. HIV is diagnosed late in Israel and LTC rates remain stagnated; higher awareness is still needed. Once in care, however, treatment and outcomes were in line with international standards.