TY - JOUR
T1 - A framework to inform strategies to improve the HIV care continuum in low- and middle-income countries
AU - Hoffmann, Christopher J.
AU - Mabuto, Tonderai
AU - McCarthy, Kerrigan
AU - Maulsby, Catherine
AU - Holtgrave, David R.
N1 - Funding Information:
Funding was received from the United States Agency for International Development (USAID) Cooperative Agreement AID-OAA-A-12-00028.
Publisher Copyright:
© 2016 The Guilford Press.
PY - 2016/8
Y1 - 2016/8
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84978734448&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84978734448&partnerID=8YFLogxK
U2 - 10.1521/aeap.2016.28.4.351
DO - 10.1521/aeap.2016.28.4.351
M3 - Article
C2 - 27427929
AN - SCOPUS:84978734448
SN - 0899-9546
VL - 28
SP - 351
EP - 364
JO - AIDS Education and Prevention
JF - AIDS Education and Prevention
IS - 4
ER -