HIV Care Continuum
ART use

The North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) began in 2006 as the North American regional representative of the International epidemiologic Databases to Evaluate AIDS (IeDEA). Comprised of over 20 collaborating cohorts, NA-ACCORD is widely representative of HIV care in the United States and Canada. Over 200 sites contribute data on over 190,000 HIV-infected participants.

NA-ACCORD has established a multi-disciplinary group of collaborators that span disciplines such as basic science, clinical research, epidemiology, data informatics and biostatistics. Collectively, our group is poised to answer the key questions in practice today. The NA-ACCORD has established a unique scientific platform to address clinical issues that are now of paramount importance in the modern treatment era.

HIV Care Continuum

Steps in the Continuum
Retention in care
ART use
HIV viral suppression

Indicator

Retention: >=2 HIV primary care visits, >90 days apart, in the year

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>=2 HIV primary care visits per calendar year, >90 days apart, among those with >=1 visit after cohort enrollment and before the end of the study period (observations in the year of cohort initiation or year of patient death are excluded); CD4 and HIV-1 RNA measurement dates were used as visit proxies in British Columbia, Argentina, and Peru. [Ford MA, and Spicer CM. Monitoring HIV care in the United States : indicators and data systems. Washington, D.C.: National Academies Press; 2012.]

ART use: On ART >=1 month in the year

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>1 month on a regimen consisting of 3 or more active antiretroviral agents per calendar year, among those with >=1 HIV primary care visit in the calendar year. [Valdiserri RO, Forsyth AD, Yakovchenko V, and Koh HK. Measuring what matters: development of standard HIV core indicators across the U.S. Department of Health and Human Services. Public Health Rep. United States; 2013;128(5):354-9.]

Viral suppression: VL < 200 copies/mL at last measure in the year

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HIV-1 RNA viral load measurement < 200 copies/mL at final viral load measure in the calendar year, among those with >=1 HIV primary care visit in the calendar year. [Valdiserri RO, Forsyth AD, Yakovchenko V, and Koh HK. Measuring what matters: development of standard HIV core indicators across the U.S. Department of Health and Human Services. Public Health Rep. United States; 2013;128(5):354-9.]

CD4 at entry: Earliest CD4 count within 6 months of entry to cohort

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Earliest CD4+ count within 6 months of (before or after) enrollment in the cohort, excluding those with any recorded ART use or HIV-1 RNA viral load < 200 copies/mL prior to the eligible CD4+ counts. [Althoff KN, Gange SJ, Klein MB, Brooks JT, Hogg RS, Bosch RJ, Horberg MA, Saag MS, Kitahata MM, Justice AC, Gebo KA, Eron JJ, Rourke SB, Gill MJ, Rodriguez B, Sterling TR, Calzavara LM, Deeks SG, Martin JN, Rachlis AR, Napravnik S, Jacobson LP, Kirk GD, Collier AC, Benson CA, Silverberg MJ, Kushel M, Goedert JJ, McKaig RG, Van Rompaey SE, Zhang J, and Moore RD. Late presentation for human immunodeficiency virus care in the United States and Canada. Clin Infect Dis. United States; 2010;50(11):1512-20.]