Challenges in the Evaluation of Interventions to Improve Engagement Along the HIV Care Continuum in the United States: A Systematic Review

Kathryn A. Risher, Sunaina Kapoor, Alice Moji Daramola, Gabriela Paz-Bailey, Jacek Skarbinski, Kate Doyle, Kate Shearer, David Dowdy, Eli Rosenberg, Patrick Sullivan, Maunank Shah

Research output: Contribution to journalArticle

Abstract

In the United States (US), there are high levels of disengagement along the HIV care continuum. We sought to characterize the heterogeneity in research studies and interventions to improve care engagement among people living with diagnosed HIV infection. We performed a systematic literature search for interventions to improve HIV linkage to care, retention in care, reengagement in care and adherence to antiretroviral therapy (ART) in the US published from 2007-mid 2015. Study designs and outcomes were allowed to vary in included studies. We grouped interventions into categories, target populations, and whether results were significantly improved. We identified 152 studies, 7 (5%) linkage studies, 33 (22%) retention studies, 4 (3%) reengagement studies, and 117 (77%) adherence studies. ‘Linkage’ studies utilized 11 different outcome definitions, while ‘retention’ studies utilized 39, with very little consistency in effect measurements. The majority (59%) of studies reported significantly improved outcomes, but this proportion and corresponding effect sizes varied substantially across study categories. This review highlights a paucity of assessments of linkage and reengagement interventions; limited generalizability of results; and substantial heterogeneity in intervention types, outcome definitions, and effect measures. In order to make strides against the HIV epidemic in the US, care continuum research must be improved and benchmarked against an integrated, comprehensive framework.

Original languageEnglish (US)
Pages (from-to)1-23
Number of pages23
JournalAIDS and Behavior
DOIs
StateAccepted/In press - Jan 24 2017

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Continuity of Patient Care
HIV
Health Services Needs and Demand
Intervention Studies
HIV Infections
Outcome Assessment (Health Care)

Keywords

  • HIV adherence
  • HIV care continuum
  • HIV linkage to care
  • HIV reengagement
  • HIV retention in care

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Challenges in the Evaluation of Interventions to Improve Engagement Along the HIV Care Continuum in the United States : A Systematic Review. / Risher, Kathryn A.; Kapoor, Sunaina; Daramola, Alice Moji; Paz-Bailey, Gabriela; Skarbinski, Jacek; Doyle, Kate; Shearer, Kate; Dowdy, David; Rosenberg, Eli; Sullivan, Patrick; Shah, Maunank.

In: AIDS and Behavior, 24.01.2017, p. 1-23.

Research output: Contribution to journalArticle

Risher, KA, Kapoor, S, Daramola, AM, Paz-Bailey, G, Skarbinski, J, Doyle, K, Shearer, K, Dowdy, D, Rosenberg, E, Sullivan, P & Shah, M 2017, 'Challenges in the Evaluation of Interventions to Improve Engagement Along the HIV Care Continuum in the United States: A Systematic Review' AIDS and Behavior, pp. 1-23. DOI: 10.1007/s10461-017-1687-8
Risher KA, Kapoor S, Daramola AM, Paz-Bailey G, Skarbinski J, Doyle K et al. Challenges in the Evaluation of Interventions to Improve Engagement Along the HIV Care Continuum in the United States: A Systematic Review. AIDS and Behavior. 2017 Jan 24;1-23. Available from, DOI: 10.1007/s10461-017-1687-8

Risher, Kathryn A.; Kapoor, Sunaina; Daramola, Alice Moji; Paz-Bailey, Gabriela; Skarbinski, Jacek; Doyle, Kate; Shearer, Kate; Dowdy, David; Rosenberg, Eli; Sullivan, Patrick; Shah, Maunank / Challenges in the Evaluation of Interventions to Improve Engagement Along the HIV Care Continuum in the United States : A Systematic Review.

In: AIDS and Behavior, 24.01.2017, p. 1-23.

Research output: Contribution to journalArticle

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