{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:36:25Z","timestamp":1787618185683,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013274","name":"Institut National d'assurance Maladie-Invalidit\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study provides a comprehensive overview of HIV care by combining cross\u2010sectional and longitudinal continuum of care (CoC) analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using national surveillance data 2014\u20132022, a five\u2010stage cross\u2010sectional CoC was calculated among people living with HIV (incl. undiagnosed): diagnosed, linked to care, retained in care, on antiretroviral therapy (ART) and virally suppressed. For the longitudinal CoC, cumulative incidences (CI) were calculated for each transition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 26\u2009191 people living with HIV. By the end of 2022, an estimated 18\u2009302 persons were living with HIV in Belgium. Of these, 92.1% were diagnosed, 90.9% linked to care, 89.2% retained in care, 87.9% on ART and 85.6% virally suppressed. One\u2010year post\u2010infection diagnosis rates were 38% (2014\u20132016), 33% (2017\u20132019) and 31% (2020\u20132022), with differences disappearing after correction for immigration timing. Time from diagnosis to care entry remained stable at 82% within 3\u2009months. Time to ART initiation and to viral load suppression reduced substantially, with 3\u2010month CIs rising from 69% and 71%, respectively (2014\u20132016), to 91% and 77% (2020\u20132022). Transitions between all stages of care were the fastest among Belgian men who have sex with men. People who inject drugs had the lowest CI for care entry and viral suppression. Cumulative incidences of ART initiation increased substantially for all key populations, exceeding 90% within 3\u2009months in 2020\u20132022, except for non\u2010Belgian heterosexuals (87%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A steady improvement in the CoC places Belgium close to the joint united nations programme on HIV\/AIDS 95\u201095\u201095 targets, although populations like people who inject drugs and migrants still face significant barriers to care. Timely diagnosis by supporting existing and innovative testing strategies should be prioritized.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.70027","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T12:36:42Z","timestamp":1748349402000},"page":"1034-1045","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Dual cross\u2010sectional and longitudinal perspective on the continuum of <scp>HIV<\/scp> care to disentangle natural epidemic evolution from real progress, Belgium 2014\u20132022"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0821-2756","authenticated-orcid":false,"given":"D.","family":"Van Beckhoven","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Public Health Sciensano  Brussels Belgium"},{"name":"Institute of Health and Society (IRSS), Universit\u00e9 Catholique de Louvain (UCLouvain)  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5542-997X","authenticated-orcid":false,"given":"B.","family":"Serrien","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health Sciensano  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2979-4321","authenticated-orcid":false,"given":"R.","family":"Demeester","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases University Hospital of Charleroi  Lodelinsart Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7125-7001","authenticated-orcid":false,"given":"J.","family":"Van Praet","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Infectious Diseases AZ Sint\u2010Jan Brugge  Brugge Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9619-1291","authenticated-orcid":false,"given":"P.","family":"Messiaen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Immunity Jessa Hospital  Hasselt Belgium"},{"name":"Faculty of Medicine and Life Sciences Hasselt University  Hasselt Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8192-1351","authenticated-orcid":false,"given":"G.","family":"Darcis","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases University Hospital of Li\u00e8ge  Li\u00e8ge Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9486-5547","authenticated-orcid":false,"given":"S.","family":"Henrard","sequence":"additional","affiliation":[{"name":"HIV Reference Centre and Internal Medicine Erasme Hospital, Universit\u00e9 Libre de Bruxelles  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5944-3530","authenticated-orcid":false,"given":"P.","family":"De Munter","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine UZ Leuven  Leuven Belgium"},{"name":"Department of Microbiology, Immunology and Transplantation KUL Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6078-878X","authenticated-orcid":false,"given":"A.","family":"Libois","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases CHU Saint\u2010Pierre, Universit\u00e9 Libre de Bruxelles  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8989-0091","authenticated-orcid":false,"given":"J.","family":"Deblonde","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health Sciensano  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(23)00028-0"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102022\u2010071392"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12603"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7502"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001120"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000003131"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i03"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1230-3"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.2900\/039534"},{"key":"e_1_2_11_11_1","unstructured":"ECDC HIV Platform tool [software application]. 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