Journal
CURRENT HIV/AIDS REPORTS
Volume 13, Issue 3, Pages 177-185Publisher
SPRINGER
DOI: 10.1007/s11904-016-0317-9
Keywords
HIV care and treatment; Retention; Sustainability; Patient activation; Treatment literacy; Social network; Social capital; Community-based care; Health maintenance
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Funding
- NIAID NIH HHS [T32 AI007641] Funding Source: Medline
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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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