Describing Engagement in the HIV Care Cascade: A Methodological Study.

Area of Science:

• Public Health
• Infectious Diseases
• Clinical Trials

Background:

• Engagement in the HIV care cascade is essential for people living with HIV (PLWH) to achieve an undetectable viral load.
• Inconsistent definitions of engagement create heterogeneity in research, making it difficult to assess participation and benefits accurately.

Purpose of the Study:

• To describe the various definitions of engagement used in HIV clinical trials.
• To highlight the diversity in engagement definitions within the HIV care cascade.

Main Methods:

• A systematic review of studies within the CASCADE database (298 HIV care cascade clinical trials) was conducted.
• Studies listing engagement as an outcome were selected and analyzed for their definitions of engagement.

Main Results:

• Of 13 eligible studies, five lacked explicit definitions for engagement.
• Commonly used definitions included appointment adherence (n=6), time specification (n=5), and intervention adherence (n=5).
• Other definitions involved laboratory testing (n=2), antiretroviral therapy adherence (n=2), and quality of interaction (n=1).

Conclusions:

• Significant diversity exists in how engagement is defined and measured in HIV care cascade research.
• A consensus on standardized definitions and measurement of engagement is recommended to improve data comparability and pooling.