A framework to inform strategies to improve the HIV care continuum in low- and middle-income countries

Christopher J. Hoffmann, Tonderai Mabuto, Kerrigan McCarthy, Catherine Maulsby, David R. Holtgrave

Research output: Contribution to journalArticlepeer-review

Abstract

Reasons for attrition along the HIV care continuum are well described. However, improving patient engagement in care has been a challenge. New approaches to understanding and responding to reasons for attrition are required. Here, with a focus on low- and middle-income countries, we propose a framework that brings together an explanatory model with social ecological levels. Individual action may be based on a conscious or unconscious balance between perceived value and perceived costs. When the balance between value and cost favors value, engagement in care can be expected. Value and cost may be mediated by levels of the individual, interpersonal interactions, the clinic experience, community, society, and policy. We encourage the use of a framework for developing strategies to improve the care continuum and believe that this framework provides a rigorous approach.

Original languageEnglish (US)
Pages (from-to)351-364
Number of pages14
JournalAIDS Education and Prevention
Volume28
Issue number4
DOIs
StatePublished - Aug 2016

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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