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Review
. 2020 Oct;17(5):458-466.
doi: 10.1007/s11904-020-00522-1.

Understanding Engagement in HIV Programmes: How Health Services Can Adapt to Ensure No One Is Left Behind

Anna Grimsrud  1   2 , Lynne Wilkinson  3   4 , Ingrid Eshun-Wilson  5 , Charles Holmes  6 , Izukanji Sikazwe  7 , Ingrid T Katz  8   9   10   11
Affiliations
Review

Understanding Engagement in HIV Programmes: How Health Services Can Adapt to Ensure No One Is Left Behind

Anna Grimsrud et al. Curr HIV/AIDS Rep. 2020 Oct.

Abstract

Purpose of review: Despite the significant progress in the HIV response, gaps remain in ensuring engagement in care to support life-long medication adherence and viral suppression. This review sought to describe the different points in the HIV care cascade where people living with HIV were not engaging and highlight promising interventions.

Recent findings: There are opportunities to improve engagement both between testing and treatment and to support re-engagement in care for those in a treatment interruption. The gap between testing and treatment includes people who know their HIV status and people who do not know their status. People in a treatment interruption include those who interrupt immediately following initiation, early on in their treatment (first 6 months) and late (after 6 months or more on ART). For each of these groups, specific interventions are required to support improved engagement. There are diverse needs and specific populations of people living with HIV who are not engaged in care, and differentiated service delivery interventions are required to meet their needs and expectations. For the HIV response to realise the 2030 targets, engagement will need to be supported by quality care and patient choice combined with empowered patients who are treatment literate and have been supported to improve self-management.

Keywords: Client-centred; Differentiated service delivery; Engagement; HIV; Re-engagement; Retention.

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Conflict of interest statement

Dr. Grimsrud reports grants from Bill and Melinda Gates Foundation, during the conduct of the study. Ms. Wilkinson has nothing to disclose. Dr. Katz has nothing to disclose. Dr. Holmes reports grants from Bill and Melinda Gates Foundation, during the conduct of the study. Dr. Sikazwe has nothing to disclose. Dr. Eshun-Wilson has nothing to disclose.

Figures

Fig. 1
Fig. 1
Schematic depiction of people living with HIV who are not in care
See this image and copyright information in PMC

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