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Retention in Care
Retention in care is critical for patients’ long-term health and suppression of viral load, which in turn reduces transmission risks to uninfected partners. Retention requires purposeful efforts to support patients’ continuous care.
What is retention in care?
Retention in care is helping people with HIV stay engaged in their medical care. Patients may need help from medical and other service providers with keeping appointments, troubleshooting obstacles to adherence to their treatment, and related regular, ongoing activities. Retention in care also includes helping patients re-enter care if they have dropped out. (For information on CDC guidance and recommendations for retention in care, refer to: http://www.cdc.gov/hiv/pwp/linkage.html)
Why do it? What are the benefits?
When patients are retained in care and adherent to prescribed treatment regimens throughout their lives, benefits include:
- Improved health outcomes and long-term survival of people living with HIV
- Prevention of transmission of HIV to partners
What are some of the barriers to retention in care?
- Lack of programs, staff, and services for retaining patients in care
- Long wait times for appointments
- Conditions, like substance abuse or mental illness, that make it harder for patients to access care on an ongoing basis
- Services not appropriately tailored to patients’ culture, language, sex, sexual orientation, age, and developmental level
What are some strategies to improve retention in care?
Individual or Provider Level
- Enhance relationship between the physician and the patient
- Assess unmet needs/barriers
- Support patients with meeting needs/problem-solving barriers to stay in care
- Encourage patients to be actively involved in advocating for their own care
- Make active referrals
System or Institutional Level
- Establish infrastructure, systems, and personnel to coordinate patient-friendly services that support patient retention in care
- Provide training or documentation on systems patients have to navigate
Who is involved to make it work?
Retention in care requires a commitment from everyone involved in providing services to a patient, including clinical, program, and administrative staff in health departments, clinics, and community based organizations.