Current HIV/AIDS Reports

, Volume 11, Issue 4, pp 376–392 | Cite as

Enhancing Linkage and Retention in HIV Care: a Review of Interventions for Highly Resourced and Resource-Poor Settings

  • N. Lance Okeke
  • Jan OstermannEmail author
  • Nathan M. Thielman
Behavioral-Bio-Medical Interface (JL Brown and RJ DiClemente, Section Editors)


Given the widespread availability of effective antiretroviral therapy, engagement of HIV-infected persons in care is a global priority. We reviewed 51 studies, published in the past decade, assessing strategies for improving linkage to and retention in HIV care. The review included studies from highly resourced settings (HRS) and resource-poor settings (RPS), specifically the USA and sub-Saharan Africa. In HRS, strength-based case management was best supported for improving linkage and retention in care; peer navigation and clinic-based health promotion were supported for improving retention. In RPS, point of care CD4 testing was best supported for improving linkage to care; decentralization, and task-shifting for improving retention. Novel interventions continue to emerge in HRS and RPS, yet many strategies have not been adequately evaluated. Further consideration should be given to analyses that identify which interventions, or combinations of interventions, are most effective, cost-effective, scalable, and aligned with patient preferences for HIV care.


HIV Antiretroviral therapy Treatment cascade Engagement in care Linkage to care Retention Healthcare utilization Patient-centered care 


Compliance with Ethics Guidelines

Conflict of Interest

N. Lance Okeke and Jan Ostermann declare that they have no conflict of interest.

Nathan M. Thielman reports receiving other support from Cubist Pharmaceuticals as a consultant and other support from The France Foundation for consultant work in developing CME activity. In addition, Dr. Thielman is a coinventor for a patent, Stable Glutamine Derivatives for Oral and Intravenous Rehydration and Nutrition Therapy issued to the University of Virginia Patents Foundation.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • N. Lance Okeke
    • 1
    • 4
  • Jan Ostermann
    • 2
    • 3
    Email author
  • Nathan M. Thielman
    • 1
    • 2
    • 5
  1. 1.Division of Infectious Diseases, Department of MedicineDuke University Medical CenterDurhamUSA
  2. 2.Duke Global Health InstituteDuke UniversityDurhamUSA
  3. 3.Duke UniversityDurhamUSA
  4. 4.DurhamUSA
  5. 5.DurhamUSA

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