Gaps identified in HIV care continuum research

February 20, 2017 by Melva Robertson

Research on the continuum of HIV care must be improved and benchmarked against an integrated, comprehensive framework in order to make strides against the HIV epidemic, according to researchers at the Rollins School of Public Health, Johns Hopkins University, and the Centers for Disease Control and Prevention.

The team performed a systematic search for interventions designed to improve the HIV care continuum – the comprehensive navigation of services that guide individuals from HIV diagnosis to linkage to care, retention in care, and reengagement and adherence to antiretroviral therapy. Interventions published from 2007-2015 were searched and assessed.

Of the 152 studies identified, researchers found that the majority of studies addressed adherence (77 percent), while many fewer addressed linkage (5 percent), retention (22 percent), or reengagement (3 percent). Researchers also noted that there was little uniformity on outcome definitions, with linkage studies utilizing 11 different outcome measures and retention studies utilizing 39 different measures.

According to Carlos del Rio, MD, Hubert Professor and chair of the Department of Global Health at the Rollins School of Public Health and clinical advisor to the Emory team of researchers,it has become clear that the biggest gap in the HIV care continuum is the retention and reengagement of persons living with HIV into effective HIV care. "This study shows precisely the point in care for which we have the fewest interventions in our toolkit. We need evidence-based interventions to help close this gap," he explains.

"Our review highlights the tremendous degree of variability across existing studies evaluating interventions to improve the HIV care continuum", explains Maunank Shah, MD, PhD, associate professor of medicine at The Johns Hopkins University School of Medicine. "We believe, as pointed out in our study, that there must be increased attention aimed at improving HIV care retention, and that researchers must report outcomes in a standardized fashion. A more comprehensive method for evaluating the HIV care continuum is needed in order to address the HIV epidemic in the United States."

The complete study is available in the January online edition of AIDS and Behavior.

Explore further: Study shows dire consequences from elevated HIV cases among US black gay men

More information: Kathryn A. Risher et al. Challenges in the Evaluation of Interventions to Improve Engagement Along the HIV Care Continuum in the United States: A Systematic Review, AIDS and Behavior (2017). DOI: 10.1007/s10461-017-1687-8

Related Stories

Study shows dire consequences from elevated HIV cases among US black gay men

November 21, 2014
Despite efforts to reduce disparities in HIV transmission among gay men and other men who have sex with men (MSM) in the United States by optimizing treatment outcomes, significant racial disparities in HIV prevalence will ...

Researchers propose a new way to assess medication-based HIV prevention

February 15, 2017
One of the most promising new approaches to slowing the spread of HIV is pre-exposure prophylaxis (PrEP), a once-a-day medication that people who don't have HIV can take to prevent becoming infected. But that strategy only ...

HIV transmission at each step of the care continuum in the United States

February 23, 2015
Individuals infected but undiagnosed with the human immunodeficiency virus (HIV) and those individuals diagnosed with HIV but not yet in medical care accounted for more than 90 percent of the estimated 45,000 HIV transmissions ...

HIV care could save lives and billions of dollars, computer model predicts

October 26, 2015
A computer model developed by Johns Hopkins health care delivery specialists predicts that strengthening a handful of efforts to keep people with HIV in lifetime care, along with more rigorous testing, would potentially avert ...

Study shows clinical and community-based linkages in Mexican primary care settings can increase physical activity levels

January 30, 2017
Integrating physical activity counseling in Mexico's primary care settings and providing referrals to community-based programming appear to be effective strategies to help patients increase their physical activity levels, ...

CDC: fewer blacks consistently retained in HIV care

February 8, 2016
(HealthDay)—Fewer blacks are consistently retained in HIV care compared with other racial/ethnic groups, according to research published in the Feb. 5 issue of the U.S. Centers for Disease Control and Prevention's Morbidity ...

Recommended for you

Scientists divulge latest in HIV prevention

July 25, 2017
A far cry from the 1990s "ABC" campaign promoting abstinence and monogamy as HIV protection, scientists reported on new approaches Tuesday allowing people to have all the safe sex they want.

Girl's HIV infection seems under control without AIDS drugs

July 24, 2017
A South African girl born with the AIDS virus has kept her infection suppressed for more than eight years after stopping anti-HIV medicines—more evidence that early treatment can occasionally cause a long remission that, ...

Meds by monthly injection might revolutionize HIV care (Update)

July 24, 2017
Getting a shot of medication to control HIV every month or two instead of having to take pills every day could transform the way the virus is kept at bay.

Candidate AIDS vaccine passes early test

July 24, 2017
The three-decade-old quest for an AIDS vaccine received a shot of hope Monday when developers announced that a prototype triggered the immune system in an early phase of human trials.

Paris spotlight on latest in AIDS science

July 21, 2017
Some 6,000 HIV experts gather in Paris from Sunday to report advances in AIDS science as fading hopes of finding a cure push research into new fields.

Scientists elicit broadly neutralizing antibodies to HIV in calves

July 20, 2017
Scientists supported by the National Institutes of Health have achieved a significant step forward, eliciting broadly neutralizing antibodies (bNAbs) to HIV by immunizing calves. The findings offer insights for HIV vaccine ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.