Why OIG Did This Review. Human Immunodeficiency Virus (HIV) is a virus that infects tens of thousands of people in the United States (U.S.) each year. While HIV affects people from all walks of life; the epidemic continues to disproportionately impact gay and bisexual men; transgender people; youth ages 13-24; and Black and Hispanic/Latino people. People diagnosed with HIV need regular care to improve their health outcomes, reduce HIV-related deaths, and ultimately reduce new HIV transmissions. The ultimate goal of HIV care is to achieve viral suppression - meaning that the amount of HIV in the body is very low or undetectable in viral load tests. At the individual level, viral suppression allows people with HIV to stay healthy, enjoy an improved quality of life, and live longer than if they were not virally suppressed. At the population level, viral suppression prevents transmission of HIV because people with HIV who reach and maintain viral suppression have effectively no risk of passing HIV to others. Lack of viral suppression among people with HIV is often attributed to appropriate care not being initiated or not being regularly received. The Department of Health and Human Services (HHS) recognizes the importance of HIV care and developed guidelines on the clinical needs of people with HIV to achieve viral suppression. The Medicaid program plays a critical role in ensuring that people with HIV receive care that can improve their ability to achieve and maintain viral suppression. In 2018, Medicaid covered an estimated 40 percent of all nonelderly people with HIV in the U.S. People with HIV who are covered by Medicaid also tend be part of populations disproportionately impacted by HIV overall, including Black and Hispanic/Latino people.
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