Zenodo
From HIV diagnosis to viral suppression: Rethinking care-cascade failure through actionable surveillance, early warning, and targeted intervention
By 1*Jane Ifeyinwa Anatuanya, 2Ndubisi Ubaka Edebeatu, 3Ogechi Njoku.
Abstract
Background
Despite highly effective antiretroviral therapy (ART), substantial losses persist between HIV diagnosis, linkage to care, retention, and durable viral suppression. Conventional care-cascade indicators remain indispensable, but they largely describe attrition after it has occurred, limiting their usefulness for timely intervention.
Objective
To examine HIV care-cascade failure through a prospective, response-oriented lens and to ask how surveillance systems can identify emerging vulnerability before adverse outcomes become entrenched.
Methods
Structured narrative review of peer-reviewed literature, national surveillance reports, and public-health guidance on care-cascade disruption, HIV surveillance, cluster detection and response, data integration, predictive analytics, and engagement interventions.