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Understanding Sustained Retention in HIV/AIDS Care and Treatment: a Synthetic Review

  • The Global Epidemic (SH Vermund, Section Editor)
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Abstract

Sustained retention represents an enduring and evolving challenge to HIV treatment programs in Africa. We present a theoretical framework for sustained retention borrowing from ecologic principles of sustainability and dynamic adaptation. We posit that sustained retention from the patient perspective is dependent on three foundational principles: (1) patient activation: the acceptance, prioritization, literacy, and skills to manage a chronic disease condition, (2) social normalization: the engagement of a social network and harnessing social capital to support care and treatment, and (3) livelihood routinization: the integration of care and treatment activities into livelihood priorities that may change over time. Using this framework, we highlight barriers specific to sustained retention and review interventions addressing long-term, sustained retention in HIV care with a focus on Sub-Saharan Africa.

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Authors and Affiliations

  1. University of California San Francisco, San Francisco, USA

    Monika Roy, Saurabh Chavan & Elvin Geng

  2. University of California Berkeley, Berkeley, USA

    Nancy Czaicki & Nancy Padian

  3. Centre for Infectious Diseases Research Zambia, Zambia, Africa

    Charles Holmes & Izukanji Sikazwe

  4. Johns Hopkins University, Baltimore, USA

    Charles Holmes

  5. Ministry of Health and Child Care, Zimbabwe, Africa

    Apollo Tsitsi

  6. Kenya Medical Research Institute, Center for Microbiology Research, Nairobi, Kenya

    Thomas Odeny

  7. University of Washington, Seattle, USA

    Thomas Odeny

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  1. Monika Roy
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Correspondence to Monika Roy.

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Monika Roy, Nancy Czaicki, Charles Holmes, Saurabh Chavan, Apollo Tsitsi, Thomas Odeny, Izukanji Sikazwe, Nancy Padian, and Elvin Geng declare that they have no conflict of interest.

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Roy, M., Czaicki, N., Holmes, C. et al. Understanding Sustained Retention in HIV/AIDS Care and Treatment: a Synthetic Review. Curr HIV/AIDS Rep 13, 177–185 (2016). https://doi.org/10.1007/s11904-016-0317-9

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