Abstract
A systematic literature review was conducted to identify predictors of poor adult retention in HIV medical care in developed and developing countries. An electronic search was conducted with MEDLINE (OVID), PubMED, EBSCO, SCOPUS, and Cochrane databases, as well as manual searches. Original, quantitative, adult studies in English, published between 1995 and 2015 were included. Only those with a focus on predictors of retention in care were reported on. Of the 345 articles identified, thirty were included following an independent assessment by two raters. In developed countries, the most frequently cited predictors of poor retention were active substance use and demographic factors. In developing countries, physical health factors were most frequently associated with poor retention in care. The results from this review suggests primary concerns for poor retention include substance use and physical health factors. Other psychosocial factors, such as psychiatric illness and social/welfare factors, were also found to be relevant.
Similar content being viewed by others
References
World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. 2016. http://apps.who.int/iris/bitstream/10665/208825/1/9789241549684_eng.pdf?ua=1. Accessed 4 Aug 2016.
Centers for Disease Control and Prevention. Vital signs: HIV prevention through care and treatment—United States. CDC. 2011;60(47):1618–1623. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6047a4.htm. Accessed 12 Mar 2016.
The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2015. Sydney: The Kirby Institute, UNSW Australia.
National Institutes of Health. Starting antiretroviral treatment early improves outcomes for HIV-infected individuals. https://www.nih.gov/news-events/news-releases/starting-antiretroviral-treatment-early-improves-outcomes-hiv-infected-individuals. Accessed 30 May 2016.
Charania MR, Marshall KJ, Lyles CM, Crepaz N, Kay LS, Koenig LJ, et al. Identification of evidence-based interventions for promoting HIV medication adherence: findings from a systematic review of US-based studies, 1996–2011. AIDS Behav. 2014;18(4):646–60.
Young B. The importance of retention in HIV care. Medscape. 2014. http://www.medscape.com/viewarticle/831324. Accessed 28 Apr 2015.
Tedaldi EM, Richardson JT, Debes R, Young B, Chmiel JS, Durham MD, et al. Retention in care within 1 year of initial HIV care visit in a multisite US cohort: who’s in and who’s out?. J Int Assoc Provid AIDS Care. 2014;13:232–41.
European AIDS Clinical Society. EACS European Guidelines for treatment of HIV infected adults in Europe. http://www.eacsociety.org/Guidelines.aspx. Accessed 28 Apr 2015.
Moher D, Shamseer L, Clarke D, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. BMJ. 2015;349:g7647.
Tobias CR, Cunningham W, Cabral HD, Cunningham CO, Eldred L, Naar-King S, et al. Living with HIV but without medical care: barriers to engagement. AIDS Patient Care STDs. 2007;21:426–34.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.
Nosyk B, Lourenço L, Min JE, Shopin D, Lima VD, Montaner JS, et al. Characterizing retention in HAART as a recurrent event process: insights into ‘cascade churn’. AIDS. 2015;29(13):1681–9.
The United Nations. World economic situation and prospects. http://www.un.org/en/development/desa/policy/wesp/wesp_current/2014wesp_country_classification.pdf. Accessed 7 Dec 2015.
Althoff AL, Zelenev A, Meyer JP, Fu J, Brown SE, Vagenas P, et al. Correlates of retention in HIV care after release from jail: results from a multi-site study. AIDS Behav. 2013;17(Suppl 2):S156–70.
Giordano TP, Hartman C, Gifford AL, Backus LI, Morgan RO. Predictors of retention in HIV care among a national cohort of US veterans. HIV Clin Trials. 2009;10(5):299–305.
Lourenço L, Colley G, Nosyk B, Shopin D, Montaner JSG, Lima VD. High levels of heterogeneity in the HIV cascade of care across different population subgroups in British Columbia, Canada. PLoS ONE. 2014;9:e115277.
Rebeiro P, Althoff KN, Buchacz K, Gill J, Horberg M, Krentz H, et al. Retention among North American HIV-infected persons in clinical care, 2000–2008. JAIDS. 2013;62:356–62.
McMahon JH, Moore R, Eu B, Tee B-K, Chen M, El-Hayek C, et al. Clinic network collaboration and patient tracing to maximize retention in HIV care. PLoS ONE. 2015;10:e0127726.
Blank AE, Fletcher J, Verdecias N, Garcia I, Blackstock O, Cunningham C. Factors associated with retention and viral suppression among a cohort of HIV+ women of color. AIDS Patient Care STDS. 2015;29(Suppl 1):S27–35.
Horberg MA, Hurley LB, Klein DB, Towner WJ, Kadlecik P, Antoniskis D, et al. The HIV care cascade measured over time and by age, sex, and race in a large national integrated care system. AIDS Patient Care STDs. 2015;29(11):582–90.
Richey LE, Halperin J, Pathmanathan I, Van Sickels N, Seal PS. From diagnosis to engagement in HIV care: assessment and predictors of linkage and retention in care among patients diagnosed by emergency department based testing in an urban public hospital. AIDS Patient Care STDs. 2014;28(6):277–9.
Adams JW, Brady KA, Michael YL, Yehia BR, Momplaisir FM. Postpartum engagement in HIV care: an important predictor of long term retention in care and viral suppression. Clin Infect Dis. 2015;61(12):1880–7.
Dombrowski JC, Simoni JM, Katz DA, Golden MR. Barriers to HIV care and treatment among participants in a public health HIV care relinkage program. AIDS Patient Care STDs. 2015;29:279–87.
Schafer KR, Brant J, Gupta S, Thorpe J, Winstead-Derlega C, Pinkerton R, et al. Intimate partner violence: a predictor of worse HIV outcomes and engagement in care. AIDS Patient Care STDs. 2012;26(6):356–65.
Waldrop-Valverde D, Guo Y, Ownby RL, Rodriguez A, Jones DL. Risk and protective factors for retention in HIV care. AIDS Behav. 2014;18(8):1483–91.
Kelly JD, Hartman C, Graham J, Kallen MA, Giordano TP. Social support as a predictor of early diagnosis, linkage, retention, and adherence to HIV care: results from the steps study. J Assoc Nurses AIDS Care. 2014;25(5):405–13.
Boyles TH, Wilkinson LS, Leisegang R, Maartens G. Factors influencing retention in care after starting antiretroviral therapy in a rural South African programme. PLoS ONE. 2011;6(5):e19201.
Charurat M, Oyegunle M, Benjamin R, Habib A, Eze E, Ele P, et al. Patient retention and adherence to antiretrovirals in a large antiretroviral therapy program in Nigeria: a longitudinal analysis for risk factors. PLoS ONE. 2010;5(5):e10584.
Janssen S, Wieten RW, Stolp S, Cremers AL, Rossatanga EG, Klipstein-Grobusch K, Belard S, Grobusch MP. Factors associated with retention to care in an HIV clinic in Gabon, Central Africa. PLoS ONE. 2015;10(10):e0140746.
Koole O, Tsui S, Wabwire-Mangen F, Kwesigabo G, Menten J, Mulenga M, et al. Retention and risk factors for attrition among adults in antiretroviral treatment programmes in Tanzania, Uganda and Zambia. Trop Med Int Health. 2014;19(12):1397–410.
Mekuria LA, Prins JM, Yalew AW, Sprangers MAG, Nieuwkerk PT. Retention in HIV care and predictors of attrition from care among HIV-infected adults receiving combination anti-retroviral therapy in Addis Ababa. PLoS ONE. 2015;10(6):e0130649.
Mutasa-Apollo T, Shiraishi RW, Takarinda KC, Dzangare J, Mugurungi O, Murungu J, et al. Patient retention, clinical outcomes and attrition-associated factors of HIV-infected patients enrolled in Zimbabwe’s National Antiretroviral Therapy Programme, 2007–2010. PLoS ONE. 2014;9(1):e86305.
Thida A, Tun STT, Zaw SKK, Lover AA, Cavailler P, Chunn J, et al. Retention and risk factors for attrition in a large public health ART program in Myanmar: a retrospective cohort analysis. PLoS ONE. 2014;9(9):e108615.
Ugoji C, Okere N, Dakum P, Ake-Uzoigwe R, Igboelina D, Ndembi N, Ekong E, Charurat M, Blattner WA. Correlates of patient retention in HIV care and treatment programs in Nigeria. Curr HIV Res. 2015;13(4):300–7.
Vella V, Govender T, Dlamini S, Taylor M, Moodley I, David V, et al. Retrospective study on the critical factors for retaining patients on antiretroviral therapy in KwaZulu-Natal, South Africa. JAIDS. 2010;55(1):109–16.
Yang GL, Yan J, Liu Y, Huang ZL, Long S. Retention in care and factors affecting it among people living with HIV/AIDS in Changsha city, China. Asia-Pacific J Public Health. 2015;27(2 suppl):86S–92S.
Allam RR, Murhekar MV, Bhatnagar T, Uthappa CK, Chava N, Rewari BB, et al. Survival probability and predictors of mortality and retention in care among patients enrolled for first-line antiretroviral therapy, Andhra Pradesh, India, 2008–2011. Trans R Soc Trop Med Hyg. 2014;108:198–205.
Palombi L, Marazzi MC, Guidotti G, Germano P, Buonomo E, Scarcella P, et al. Incidence and predictors of death, retention, and switch to second-line regimens in antiretroviral-treated patients in sub-Saharan African Sites with comprehensive monitoring availability. Clin Infect Dis. 2009;48(1):115–22.
Vuylsteke B, Semdé G, Auld AF, Sabatier J, Kouakou J, Ettiègne-Traoré V, et al. Retention and risk factors for loss to follow-up of female and male sex workers on antiretroviral treatment in Ivory Coast: a retrospective cohort analysis. JAIDS. 2015;68:S99–106.
Krumme AA, Kaigamba F, Binagwaho A, Murray MB, Rich ML, Franke MF. Depression, adherence and attrition from care in HIV-infected adults receiving antiretroviral therapy. J Epidemiol Community Health. 2014;69:284–9.
National Institute on Drug Abuse. Drugs, brain and behavior: the science of addiction. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain. Accessed 20 Mar 2016.
Hull P, Mao L, Kao S-C, Edwards B, Prestage G, Zablotska I, et al. Gay Community Periodic Survey: Sydney 2013. Sydney: National Centre in HIV Social Research, University of New South Wales.
Hatzenbuehler ML. How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychol Bull. 2009;135(5):707.
Springer SA, Dushaj A, Azar MM. The impact of DSM-IV mental disorders on adherence to combination antiretroviral therapy among adult persons living with HIV/AIDS: a systematic review. AIDS Behav. 2012;16(8):2119–43.
Sayles JN, Wong MD, Kinsler JJ, Martins D, Cunningham WE. The association of stigma with self-reported access to medical care and antiretroviral therapy adherence in persons living with HIV/AIDS. J Gen Intern Med. 2009;24(10):1101–8.
Johnson MO, Neilands TB, Dilworth SE, Morin SF, Remien RH, Chesney MA. The role of self-efficacy in HIV treatment adherence: validation of the HIV Treatment Adherence Self-Efficacy Scale (HIV-ASES). J Behav Med. 2007;30(5):359–70.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
This article does not contain any studies with human participants or animals performed by any of the authors.
Rights and permissions
About this article
Cite this article
Bulsara, S.M., Wainberg, M.L. & Newton-John, T.R.O. Predictors of Adult Retention in HIV Care: A Systematic Review. AIDS Behav 22, 752–764 (2018). https://doi.org/10.1007/s10461-016-1644-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10461-016-1644-y