High Rates of Unplanned Care Interruption: Implications for Program Response

Area of Science:

• Public Health
• Infectious Diseases
• Health Services Research

Background:

• Unplanned care interruption (UCI) is a significant challenge for HIV programs in resource-limited settings (RLS).
• Over one-third of patients initiate antiretroviral therapy (ART) but subsequently interrupt care, leading to adverse clinical outcomes.
• Increasing ART adoption and potential funding shifts exacerbate UCI risks.

Purpose of the Study:

• To explore innovative care models for enhancing patient retention in HIV programs.
• To assess the potential of integrating patient-centered chronic care models into HIV service delivery.
• To identify strategies for strengthening existing chronic care elements in President's Emergency Fund for AIDS Relief (PEPFAR)-supported clinics.

Main Methods:

• Review of current HIV program challenges and patient retention strategies in RLS.
• Analysis of the applicability of chronic care models to HIV management.
• Evaluation of existing chronic care components within PEPFAR-supported HIV clinics.

Main Results:

• UCI affects a substantial proportion of patients on ART in RLS.
• Patient-centered chronic care models offer a framework to address retention challenges.
• PEPFAR clinics have partially integrated chronic care elements, indicating a foundation for comprehensive approaches.

Conclusions:

• Innovative models are crucial for improving HIV care retention amidst increasing ART access and funding uncertainties.
• Integrating patient-centered chronic care principles can enhance patient adherence and outcomes.
• Strategic development of comprehensive chronic care approaches is needed for sustainable HIV program success.