Barriers and Facilitators to Interventions Improving Retention in HIV Care: A Qualitative Evidence Meta-Synthesis

Retention in HIV care is vital to the HIV care continuum. The current review aimed to synthesize qualitative research to identify facilitators and barriers to HIV retention in care interventions. A qualitative evidence meta-synthesis utilizing thematic analysis. Prospective review registration was m...

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Bibliographic Details
Published in:AIDS and behavior 2017-06, Vol.21 (6), p.1755-1767
Main Authors: Hall, Brian J., Sou, Ka-Lon, Beanland, Rachel, Lacky, Mellanye, Tso, Lai Sze, Ma, Qingyan, Doherty, Meg, Tucker, Joseph D.
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adolescent
Adolescents
AIDS
Antiretroviral drugs
Attitude of Health Personnel
Attrition
Barriers
Caregivers
Case management
Constraints
Continuity of Patient Care - statistics & numerical data
Developing countries
Discrimination
Discrimination, Psychological
Dynamic programming
Fear
Feasibility studies
Female
Females
Health
Health Facilities - statistics & numerical data
Health problems
Health Psychology
Health Services Accessibility
HIV
HIV Infections - drug therapy
HIV Infections - psychology
Human immunodeficiency virus
Humans
Income
Infectious Diseases
Intervention
LDCs
Low income groups
Medical personnel
Medicine
Medicine & Public Health
Methadone
Original Paper
Public Health
Qualitative analysis
Qualitative research
Quality assessment
Quality control
Retention
Reviews
Social Stigma
Social Support
Stigma
Synthesis
Systematic review
Telemedicine
Workers
Citations: Items that this one cites
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Summary:Retention in HIV care is vital to the HIV care continuum. The current review aimed to synthesize qualitative research to identify facilitators and barriers to HIV retention in care interventions. A qualitative evidence meta-synthesis utilizing thematic analysis. Prospective review registration was made in PROSPERO and review procedures adhered to PRISMA guidelines. Nineteen databases were searched to identify qualitative research conducted with individuals living with HIV and their caregivers. Quality assessment was conducted using CASP and the certainty of the evidence was evaluated using CERQual. A total of 4419 citations were evaluated and 11 were included in the final meta-synthesis. Two studies were from high-income countries, 3 from middle-income countries, and 6 from low-income countries. A total of eight themes were identified as facilitators or barriers for retention in HIV care intervention: (1) Stigma and discrimination, (2) Fear of HIV status disclosure, (3) task shifting to lay health workers, (4) Human resource and institutional challenges, (5) Mobile Health (mHealth), (6) Family and friend support, (7) Intensive case management, and, (8) Relationships with caregivers. The current review suggests that task shifting interventions with lay health workers were feasible and acceptable. mHealth interventions and stigma reduction interventions appear to be promising interventions aimed at improving retention in HIV care. Future studies should focus on improving the evidence base for these interventions. Additional research is needed among women and adolescents who were under-represented in retention interventions.
ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-016-1537-0