Attachments
Overview
This policy brief provides an overview of the complexities and challenges of people re-engaging in HIV treatment services. It highlights person-centred interventions that address the reasons for disengagement, the importance of providing support at re-engagement tailored to individual needs and country examples of tracing and re-engagement interventions. The brief summarizes WHO guidance and emphasizes the importance of implementing relevant recommendations to support adherence, continuous engagement, tracing and sustained re-engagement.
This brief aims to assist health policy-makers, health ministries, practitioners, implementers and communities to improve understanding of the various challenges and solutions for re-engaging individuals to support better health outcomes. It provides guidance on supporting people living with HIV to sustain re-engagement without further interruptions in treatment and care. The goal is to reduce HIV-related morbidity and mortality, prevent new infections and the risk of drug resistance.
Key messages
- People who have been diagnosed with HIV may disengage from care after starting antiretroviral therapy (ART) and may do so more than once.
- Individuals with interrupted HIV care and treatment may reengage to care with advanced HIV disease and a range of clinical, psychosocial and service delivery needs.
- WHO recommends tracing people who have disengaged from care and providing support for re-engagement back in care, including adherence support and diferentiated service delivery for HIV treatment to reduce the risk of future disengagement.
- Health-care providers must refrain from punitive actions and ensure a welcoming, non-stigmatizing environment and equitable access to services.
- Programmes should engage communities at diferent levels to ensure efective re-engagement strategies tailored to clients’ needs.
- When diferentiated service delivery pathways are designed at reengagement, factors such as the clinical profile, the diverse needs and reasons for disengagement and specific population needs should be considered; person-centred solutions should be explored.
- How engagement in care and treatment is supported and measured urgently needs to be improved, including close monitoring of treatment adherence and viral suppression and identifying and responding to inconsistent patterns of retention in care.
- Sustained engagement in HIV care and treatment is critical to achieving sustained undetectable viral load and optimal clinical and public health outcomes.