title: The South Carolina HIV Cascade of Care.
abstract: OBJECTIVE
  In recent years, the human immunodeficiency virus (HIV) cascade of care describing the spectrum of engagement in HIV care from diagnosis to virologic suppression has been used widely in determining the progress and success in public health efforts to control the HIV epidemic. For more than a decade South Carolina consistently ranked among the top10 states in the United States with the highest acquired immunodeficiency syndrome case rates, suggesting late diagnoses and issues with retention in care. The primary objective of this study was to develop an HIV cascade of care for the state that may help identify opportunities for appropriate future interventions.
  
  
  METHODS
  The South Carolina Enhanced HIV/AIDS Reporting System database was used to develop the HIV cascade of care indicating the percentages of the diagnosed individuals who were linked to care, received any care, were retained in care, and achieved virologic suppression using standardized metrics recommended by the Centers for Disease Control and Prevention. The sample included all individuals in South Carolina who were diagnosed as having HIV by December 31, 2011 and who were alive at the end of 2012.
  
  
  RESULTS
  Of the 14,523 South Carolinians living with HIV at the end of 2012, 64% had received any HIV care, 53% were retained in care, and 48% were virologically suppressed during 2012.
  
  
  CONCLUSIONS
  This is the first HIV cascade of care model for South Carolina. Efforts are needed to improve public health initiatives to link, engage, and retain individuals with HIV in care.
authors.affiliation: From the Departments of Infectious Diseases and Medicine, University of South Carolina, and the University of South Carolina Arnold School of Public Health, Columbia.
authors.forename: Babatunde
authors.initials: B
authors.lastname: Edun
authors.affiliation: From the Departments of Infectious Diseases and Medicine, University of South Carolina, and the University of South Carolina Arnold School of Public Health, Columbia.
authors.forename: Medha
authors.initials: M
authors.lastname: Iyer
authors.affiliation: From the Departments of Infectious Diseases and Medicine, University of South Carolina, and the University of South Carolina Arnold School of Public Health, Columbia.
authors.forename: Helmut
authors.initials: H
authors.lastname: Albrecht
authors.affiliation: From the Departments of Infectious Diseases and Medicine, University of South Carolina, and the University of South Carolina Arnold School of Public Health, Columbia.
authors.forename: Sharon
authors.initials: S
authors.lastname: Weissman
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D013022:South Carolina / Q000453:epidemiology; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects*