The methodology used to develop the Houston EMA Treatment Cascade:

  1. HIV Infected: Total number of HIV infected persons (both aware/diagnosed and unaware/undiagnosed) in the Houston EMA, 2012. Source: TXDSHS, Program Planning and Evaluation Group, HIV/STD Branch, August 2013.  
    Definition: unaware/undiagnosed persons have been estimated at 18.1% using a national calculation (CDC, June 2012). This is in addition to the number of HIV+ individuals (alive) residing in Texas at the end of 2012 (Texas eHARS data as of July 2013).

  2. HIV Diagnosed: Number of HIV-infected persons who are aware of their HIV diagnosis, alive, and residing in the Houston EMA, 2012. Source: Texas eHARS data as of July 2013. Source: Texas eHARS data as of July 2012 and HIV Services Unmet Need Project.
    Definition
    : number of adults and adolescents (>= 13 years of age as of end of the year 2011) residing in Texas diagnosed with HIV infection through 2012 and living with HIV infection on 12/31/2012.

  3. In HIV Care: of diagnosed persons in the Houston EMA who have a “met need” for HIV care, 2012. Source: TXDSHS, HIV Unmet Need Project, 2012
    Definition
    : evidence of ³ 1 of the following in the previous 12 months: (1) an HIV primary medical care visit, (2) a prescription for HIV medication, or (3) an HIV monitoring test (e.g., a viral load or CD-4 test) (HRSA). Data sources are: eHARS, ELR, ARIES, ADAP, Medicaid, and private payer data.

  4. Retained in HIV Care: Number of diagnosed persons retained in HIV care in the Houston EMA, 2012. Source: TXDSHS, TXDSHS, HIV Unmet Need Project, 2012.  
    Definition
    : evidence of ≥ 2 primary care visits or HIV monitoring tests at least 3 to 6 months apart in a 12-month period (NHAS). Data sources are: eHARS, ELR, ARIES, ADAP, Medicaid, and private payer data.

  5. Suppressed Viral Load: Number of diagnosed persons with viral load suppression (VL test <= 200 copies/mL) at last lab visit in the Houston EMA, 2012. Source: Texas Electronic Lab Records, 2012.