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Step 4: Keeping HIV-Positive People in Quality HIV Care

Since there is no cure for HIV/AIDS, continual follow-up care is essential for effective, long-term management of the disease. Keeping people in care is often referred to as retention or engagement. Retention in care is often defined as visiting a clinic twice during a calendar year, spaced approximately 2-6 months apart. Engagement in care is often defined more broadly, encompassing visits to clinics as well as adherence to drug regimens and other clinical or lifestyle-change recommendations made by providers. Unfortunately, the CDC estimates that, in 2011, only about 40% of people living with HIV in the U.S. were receiving regular HIV care.

Individuals may stop engaging in HIV care for many reasons. A person diagnosed with HIV is generally prescribed antiretroviral therapy (ART), which requires daily medication dosages in order to work effectively. Though the complexity of ART regimens has decreased over time, adhering to this daily regimen requires significant effort on the part of the individual and can be challenging for individuals with other healthcare or behavioral health issues or a lack of financial resources.

Resources to Learn More

Linkage to, Retention in, and Re-engagement in HIV Care (LRC)
This chapter in the CDC's “Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention” is written for care providers and people working on prevention initiatives. It describes a number of programs and practices that have been tested and found successful in increasing patient retention in care.
Organization(s): Centers for Disease Control and Prevention
Date: 4/2016

Retaining HIV-Infected Patients in Care: Where Are We? Where Do We Go from Here?
This review article provides a broad overview of the current research on retaining and engaging with HIV-infected patients in quality, continuous HIV care. It identifies problems that commonly occur when trying to retain patients in care, describes which types of patients may be at greatest risk for loss to follow-up, and suggests some promising and evidence-based practices for increasing retention in care.
Author(s): Horstmann, E., Brown, J., Islam, F., Buck, J., & Agins, B.
Citation: Clinical Infectious Diseases, 50(5), 752-61
Date: 3/2010