Retention in Care among HIV-Infected Patients in Resource-Limited Settings: Emerging Insights and New Directions

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From: Current HIV/AIDS Reports(Vol. 7, Issue 4)
Publisher: Springer
Document Type: Report
Length: 238 words

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Byline: Elvin H. Geng (1), Denis Nash (1), Andrew Kambugu (1), Yao Zhang (1), Paula Braitstein (1), Katerina A. Christopoulos (1), Winnie Muyindike (1), Mwebesa Bosco Bwana (1), Constantin T. Yiannoutsos (1), Maya L. Petersen (1), Jeffrey N. Martin (1) Keywords: HIV care and treatment; Retention in care; Resource-limited settings; Loss to follow-up; Access to care Abstract: In resource-limited settings--where a massive scale up of HIV services has occurred in the last 5 years--both understanding the extent of and improving retention in care presents special challenges. First, retention in care within the decentralizing network of services is likely higher than existing estimates that account only for retention in clinic, and therefore antiretroviral therapy services may be more effective than currently believed. Second, both magnitude and determinants of patient retention vary substantially and therefore encouraging the conduct of locally relevant epidemiology is needed to inform programmatic decisions. Third, socio-structural factors such as program characteristics, transportation, poverty, work/child care responsibilities, and social relations are the major determinants of retention in care, and therefore interventions to improve retention in care should focus on implementation strategies. Research to assess and improve retention in care for HIV-infected patients can be strengthened by incorporating novel methods such as sampling-based approaches and a causal analytic framework. Author Affiliation: (1) Division of HIV/AIDS at San Francisco General Hospital, 995 Potrero Avenue, Building 80, San Francisco, CA, 94110, USA Article History: Registration Date: 23/08/2010 Online Date: 07/09/2010

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Gale Document Number: GALE|A237055660