The Impact of Ancillary HIV Services in Improving Retention in Care and How They Can Be Prioritized and Allocated to Maximize Outcomes
DOI:
https://doi.org/10.14738/bjhr.1203.18791Keywords:
Ancillary HIV services, retention in care, impact, outcomesAbstract
Background: Community programs play a vital role in providing ancillary HIV services, including prevention, treatment, and support. This scoping review aims to synthesize evidence on the impact of ancillary services on retention in care and identify strategies to prioritize and allocate resources effectively. Methods: A comprehensive search of peer-reviewed literature published in the last decade was conducted. Fifteen studies were selected based on predetermined inclusion criteria, and data were extracted and analyzed to identify key themes and findings. Results: Community programs offering a range of services, including HIV testing and counseling, ART provision and follow-up, nutrition support, psychosocial support, and financial support, were found to positively impact care retention. These programs increased access to ART, improved adherence, enhanced treatment outcomes, and reduced loss to follow-up. A patient-centered approach to chronic disease care was also identified as an effective strategy to empower patients to manage their condition. Conclusion: This scoping review highlights the importance of community programs in improving retention in care and treatment outcomes for individuals living with HIV. Decentralizing HIV services through community-based initiatives is a promising strategy to increase access to essential health services. Policymakers, managers, and healthcare providers should recognize the value of community programs and work to enhance and support their role in the response to the HIV epidemic.
References
Aliyu, M.H., Blevins, M., Audet, C.M., Kalish, M., Gebi, U., Onwujekwe, O. et al. (2016). Integrated prevention of mother-to-child HIV transmission services, antiretroviral therapy initiation, and maternal and infant retention in care in rural north-central Nigeria: a cluster-randomized control trial. Lancet HIV. http://dx.doi.org/10.1016/s2352-3018(16)00018-7
Altice, F., Bruce, R.D., Lucas, G.M., Lum, P.J., Korthuis, P.T., Flanigan, T.P. (2011). HIV treatment outcomes among HIV-infected, opioid-dependent patients receiving buprenorphine/naloxone treatment within HIV clinical care settings: results from a multisite study. J Acquir Immune Defic Syndr; 56 (Suppl 1):S22–S32.
Bassett, I.V., Wang, B. & Chetty, S. (2009). Loss to care and death before antiretroviral therapy in Durban, South Africa. J Acquir Immune Defic Syndr.; 9;51:135–139. 10.1097/qai.0b013e3181a44ef2.
Bemelmans, M., Baert, S., Negussie, E., Bygrave, H., Biot, M., Jamet, C., ... & Ford, N. (2016). Sustaining the future of HIV counselling to reach 90‐90‐90: a regional country analysis. Journal of the International AIDS Society, 19(1), 20751.
Bisson, G.P., Gaolathe, T. & Gross, R. (2008). Overestimates of survival after HAART: implications for global scaleup efforts. PLoS ONE; 3:e1725. 10.1371/journal.pone.0001725.
Busza, J., Dauya, E., Bandason, T., Simms, V., Chikwari, C. D., Makamba, M., ... & Ferrand, R. A. (2018). The role of community health workers in improving HIV treatment outcomes in children: lessons learned from the ZENITH trial in Zimbabwe. Health policy and planning, 33(3), 328-334.
Chan, P.A. (2018). Evidence-based strategies to Address Retention in HIV Care. Capacity Building Assistance (CBA) National Webcast In collaboration with Clinical Directors Network, Inc. (CDN). Brown University.
Centers for Disease Control and Prevention. (2020a). Behavioral and Clinical Characteristics of Persons with Diagnosed HIV Infection-Medical Monitoring, United States, 2018 Cycle (June 2018-May 2019). https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-special-report-number-25.pdf
Centers for Disease Control and Prevention (2020b). Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data United States and 6 Dependent Areas, 2018 HIV Surveillance Supplemental Report; 25(No. 2):1-104. 112
Centers for Disease Control and Prevention (2024). Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 territories and freely associated states, 2022. HIV Surveillance Supplemental Report 2024; 29(No. 2).
Cheever, L.W. (2007). Engaging HIV-infected patients in care: their lives depend on it. Clin Infect Dis.; 44:1500–1502. 10.1086/517534.
Chin, J.J., Botsko, M., Behar, E. & Finkelstein, R. (2009). More than ancillary: HIV social services, intermediate outcomes and quality of life. AIDS Care. Vol. 21, No. 10: 1289-1297
Curry, N. & Ham, C. (2010). Clinical and service integration: the route to improved outcomes. Sugarman J, editor. London: The Kings Fund. https://www.kingsfund.org.uk/sites/files/kf/Clinical-and-service-integration-Natasha-Curry-Chris-Ham-22-November-2010.pdf
Dasgupta, S., Tie, Y. Beer, L. & Weiser. J. (2022). Unmet needs for ancillary care services are associated with HIV clinical outcomes among adults with diagnosed HIV. AIDS Care; 34(5): 606–614. 10.1080/09540121.2021.1946001.
DeGroote, N.P., Korhonen, L.C., Shouse, R.L., Valleroy, L.A. & Bradley, H. (2016). Unmet Needs for Ancillary Services Among Men Who Have Sex with Men and Who Are Receiving HIV Medical Care — United States, 2013–2014. MMWR Morb Mortal Wkly Rep; 65:1004–1007. http://dx.doi.org/10.15585/mmwr.mm6537a4.
Doshi, R.K., Milberg, J. & Isenberg, D. (2015). High rates of retention and viral suppression in the US HIV safety net system: HIV care continuum in the Ryan White HIV/AIDS Program, 2011. Clin Infect Dis.; 60:117-25.
Durvasula, R. & Miller, T.R. (2014). Substance Abuse Treatment in Persons with HIV/AIDS: Challenges in Managing Triple Diagnosis. Behav Med. 2014; 40(2): 43–52. 10.1080/08964289.2013.866540
Etienne, M., Burrows, L., Osotimehin, B. (2010). Situational analysis of varying models of adherence support and loss to follow up rates; findings from 27 treatment facilities in eight resource limited countries. Trop Med Int Health; 15: 76–81. 10.1111/j.1365-3156.2010.02513.x.
Gallant, J., Hsue, P.Y., Shreay, S. & Meyer, N. (2017). Comorbidities among US patients with prevalent HIV infection: A trend analysis. The Journal of Infectious Diseases; 216 (12): 1525–1533. 10.1093/infdis/jix518
Geng, E.H., Emenyonu, N. & Bwana, M.B. (2008). Sampling-based approach to determining outcomes of patients lost to follow-up in antiretroviral therapy scale-up programs in Africa. JAMA; 300:506–507. 10.1001/jama.300.5.506.
Geng, E.H., Bangsberg, D.R. & Musinguzi, N. (2010). Understanding reasons for and outcomes of patients lost to follow-up in antiretroviral therapy programs in Africa through a sampling-based approach. J Acquir Immune Defic Syndr.; 53:405–411. 10.1097/QAI.0b013e3181b843f0
Geng, E.H., Nash, D., Kambugu, A., Zhang, Y., Braistein, P., Christopolous, K.A. et al. (2011). Retention in care among HIV-infected patients in resource-limited settings: Emerging insights and new directions. Curr HIV/AIDS Rep; 7(4):234-244. 10.1007/s11904-010-0061-5
Hartzler, B., Dombrowski, J.C., Crane, H.M., Eron, J.J., Geng, E.H., Christopher, M.W., Mayer, K.H., Moore, R.D., Mugavero, M.J., Napravnik, S., Rodriguez, B. & Donovan, D.M. (2017). Prevalence and predictors of substance use disorders among HIV care enrollees in the United States. AIDS and Behavior; 21(4): 1138–1148. 10.1007/s10461-016-1584-6
Health Resources and Services Administration (2019). Ryan White HIV/AIDS Program Annual Client-Level Data Report 2018:1-139. 113
Higa, D., Marks, G., Crepaz, N., Liau, A. & Lyles, C. (2012). Intervention to improve retention in HIV primary care: A systematic review of U.S. studies. Curr HIV/AIDS Rep.; 9(4): 313-325. 10.1007/s11904-012-0136-6
Hochgesang, M., Kuyenda, A. & Hosseinipour, M. (2006, Aug 13). Active tracing of ART patients lost to follow-up at Lighthouse shows that few `stopped' treatment for their own reasons, but many have died. 16th International AIDS Conference; Toronto, Canada.
Massaquoi, M, Zachariah, R. & Manzi, M. (2009). Patient retention and attrition on antiretroviral treatment at district level in rural Malawi. Trans R Soc Trop Med Hyg.; 103:594–600. 10.1016/j.trstmh.2009.02.012.
McNeil, R., Dilley, L.B., Guirguis-Younger, M., Hwang, S.W. & Small, W. (2014). Impact of supervised drug consumption services on access to and engagement with care at a palliative and supportive care facility for people living with HIV/ AIDS: a qualitative study. J Int AIDS Soc; 2014: 17.
Messeri, P.A., Abramson, D.M. & Aidala, A. A. (2002). The impact of ancillary HIV services on engagement in medical care in New York City. AIDS Care;14 (Suppl 1):S15–S29. 10.1080/09540120220149948.
Monroe, A., Lesko, C., Chander, G., Lau, B., Keruly, J., Crane, H., Amico, K., Napravnik, S., Quinlivan, E., & Mugavero, M. (2019). Ancillary service needs among persons new to HIV care and the relationship between needs and late presentation to care. AIDS care; 31(9):1131-1139. http://dx.doi.org/10.1080/09540121.2019.1576840
Muwanga, A., Easterbrook, P.J. & Schaefer, P. (2008, February 3) Losses to follow-up in a large ART program in Uganda. 15th Conference on Retroviruses and Opportunistic Infections; Boston, MA
Naar-King, S., Green, M., Wright, K., Outlaw, A., Wang, H. & Liu, H. (2007) Ancillary services and retention of youth in HIV care. AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV; 19:2, 248-251.10.1080/09540120600726958
O'Brien, N., Chi, Y.L. & Krause, K.R. (2021). Measuring Health Outcomes in HIV: Time to Bring in the Patient Experience. Ann Glob Health. 2021 Jan 5;87(1):2. 10.5334/aogh.2958.
Ochieng-Ooko, V., Ochieng, D. & Sidle, J.E. (2010). Influence of gender on loss to follow-up in a large HIV treatment programme in western Kenya. Bull World Health Organ. 10.2471/BLT.09.064329.
Offie, D.C., Obeagu, E.I., Akueshi, C., Njab, J.E., Ekanem, E.E., Dike, P.N. et al. (2021). Facilitators and barriers to retention in HIV care among HIV infected MSM attending community health center, Yaba, Lagos, Nigeria. Journal of Pharmaceutical Research, International; 33(52B): 10-19;2021.10.9734/JPRI/2021/v33i52B33593
Rabkin, M., Austin, J. & Nash, D. (2010, February 16). High patient retention rates in a multinational HIV/AIDS treatment program: The Columbia University Mother-to-Child-Plus Experience. 17th Conference on Retroviruses and Opportunistic Infections; San Francisco, CA.
Relief Web (2022). 90% of people living with HIV access treatment. https://reliefweb..int/report/nigeria/90-people-living-hiv-access-treatment.
Rebeiro, P.F., Horberg, M.A. & Gange, S.J. (2014). Strong agreement of nationally recommended retention measures from the Institute of Medicine and Department of Health and Human Services. PLoS One.; 9:e111772.
Rosen, S., Fox, M.P. & Gill, C.J. (2007). Patient retention in antiretroviral therapy programs in sub-Saharan Africa: a systematic review. PLoS Med.; 4:e298. 10.1371/journal.pmed.0040298.
Sabin, L. L., Semrau, K., DeSilva, M., Le, L. T., Beard, J. J., Hamer, D. H., ... & Vian, T. (2019). Effectiveness of community outreach HIV prevention programs in Vietnam: a mixed methods evaluation. BMC Public Health, 19, Sam-Agudu, N.A., Ramadhania, H.B., Isah, C., Erekaha, S., Fan-Osuala, C., Anaba, U. et al. (2017). The impact of structured mentor mother programs on presentation for early infant diagnosis testing in rural North-Central Nigeria: A prospective paired cohort study. J Aquir Immun Defic Syndr; 75(2): 182-189
Umeokonkwo, C.D., Onaka, C.A., Agu, P.A., Ossai, E.N., Balogun, M.S. & Ogbonnaya, L.U. (2019). Retention in care and adherence to HIV and AIDS treatment in Anambra State, Nigeria. BMC Infectious Diseases; 19:64.https://doi.org/10.1186/s12879-019-4293-8
Verinumbe, T., Katomski, A., Turpin, G., Syarif, O., Looze, P., Lalak, K. et al. (2024). Characterizing the relationship between HIV peer support groups and internalized stigma among people living with HIV in Nigeria. AIDS Behaviour; 28(3): 1068-1076. 10.1007/s10461-023-04217-7
Voisin, D.R., Edwards, T., Takahashi, L.M., Valadez‐Tapia, S., Shaha, H., Oselett, C., Bouacha, N., Dakin, A & Quinn, K. (2022). COVID‐19, Retention in HIV Care, and Access to Ancillary Services for Young Black Men Living with HIV in Chicago. AIDS and Behavior (2023) 27:535–544. https://doi.org/10.1007/s10461-022-03789-0
Ware, N.C., Idoko, J. & Kaaya, S. (2010). Social relationships explain ART adherence success in Sub-Saharan Africa: an account of resources and responsibility. 2010 In press.
Weiser, S.D., Tuller, D.M. & Frongillo, E.A. (2010). Food insecurity as a barrier to sustained antiretroviral therapy adherence in Uganda. PLoS One; 5:e10340. 10.1371/journal.pone.0010340.
WHO (2012). Retention in HIV programmes: Defining the challenges and identifying solutions. https://www.who.int/hiv/en/
Wringe, A., Roura, M. & Urassa, M. (2009). Doubts, denial and divine intervention: understanding delayed attendance and poor retention rates at a HIV treatment programme in rural Tanzania. AIDS Care; 21:632–637. 10.1080/09540120802385629.
Yehia, B.R., Stewart, L., Momplaisir, F., Mody, A., Holtzman, C.W., Jacobs, L.M., Hines, J., Mounzer, K., Glanz, K., Metlay, J.P & Shea, J.A. (2015). Barriers and facilitators to patient retentionin HIV care. BMC Infectious Diseases (2015) 15:246. 10.1186/s12879-015-0990-0
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Piring’ar Mercy Niyang, Ibrahim Bola Gobir, Joy Musa, Bitrus Mwantiyi, Bashir Zubayr, Yakubu Raji Egigogo, Kolawole Olatunbosun, Terso Usha, Mabel Ikpeme, Pamela Gado, Onyeka Igboelina, Chika Obiora-Okafor, Dolapo Ogundehin, Deus Bazira, Itunu Dave-Agboola
This work is licensed under a Creative Commons Attribution 4.0 International License.
