Table 1. Definitions of the statuses on the cyclical and linear HIV cascades.
| Status on the cascade | Definition |
|---|---|
| Cyclical cascade | |
| HIV+ modelled | Thembisa model estimate of those living with HIV in the province. |
| HIV+ diagnosed or HIV+ rediagnoseda | Known with HIV based on digitised person-level evidence, without evidence of having died or migrated out of the province. |
| Linked to HIV care or Relinked to HIV careb | Linked to HIV care based on digitised evidence of preparation for ART initiation, not yet started or restarted on ART. |
| Early ART or Early ART after restartc | Started/restarted on ART less than 6 months previously and therefore not yet eligible for viral load assessment. |
| Long-term ART or Long-term ART after restartd | Started/restarted ART at least 6 months previously and therefore expected to have had viral load assessed. |
| Disengagede | Interrupted care for >90 days. |
| Linear cascade | |
| HIV+ modelled | Thembisa model estimate of those living with HIV in the province. |
| HIV+ identified | Known with HIV based on digitised person-level evidence. |
| On ART | On ART, based on current evidence of treatment in hand. |
| VL expected | On ART, at least 6 months since naïve ART initiation. |
| VL done | VL expected, and recent viral load done. |
| VL suppressedf | VL expected with recent viral load done <1 000 copies/ml. |
| VL undetectable | VL expected with recent viral load done <50 copies/ml. |
a“HIV+ rediagnosed” describes a person who has disengaged at any point after initiating ART, i.e., was “Disengaged,” and then re-engaged by testing positive for HIV, but has not yet “Relinked to HIV care.”
bIn the era of same-day initiation, it is still possible to disengage between diagnosis and starting/restarting ART.
cA threshold of 6 months for “Early ART” was used in the context of guidelines recommending a first viral load assessment at 4 months. As newer guidelines recommend earlier assessment, it may be appropriate to reduce this threshold.
dLong-term ART statuses are further disaggregated by viral suppression sub-statuses.
eAn interruption threshold of 90 days was used in line with national reporting guidelines, i.e., >90 days with no visit for someone not previously on ART and >90 days without ART in hand for someone previously on ART.
fWhen calculating this as a percentage, the most appropriate denominator is VL expected, which consists of those people in the long-term ART status.
ART, antiretroviral therapy; VL, viral load.