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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.