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Kathryn Risher: Challenges in the evaluation of interventions to improve engagement along the HIV care continuum in the United States

Challenges in the evaluation of interventions to improve engagement along the HIV care continuum in the United States

Kathryn Risher, Ph.D, M.H.S
London School of Hygiene & Tropical Medicine

ABSTRACT:
In the United States (US), a high proportion of individuals living with HIV remain unlinked to care, disengaged from care, or incompletely adherent to antiretroviral therapy (ART). We conducted a systematic review of interventions to improve linkage to care, retention in care, re-engagement among those disengaged from care, and adherence to ART in the US. We find that the bulk of evidence (117/152 included studies) addresses adherence interventions, while a very small minority address linkage or reengagement interventions (7/152 and 4/152, respectively). There was tremendous heterogeneity in measures used to evaluate interventions. We found that most (59%) of studies report significantly improved outcomes, but the effect size was variable across studies and populations. The presentation will additionally include recommendations to address the challenges identified by the systematic review.