Carol W. Holtzman|Kathleen A. Brady|Baligh R. Yehia
Retention in Care and Medication Adherence: Current Challenges to Antiretroviral Therapy Success
National University of Lesotho|University of Pennsylvania|University of Pennsylvania
health behaviors retention hiv medical care adherence antiretroviral therapy art pose major challenges reducing new hiv infections addressing health disparities improving health outcomes andersens behavioral model health service use provides conceptual framework understanding patient environmental factors affect health behaviors outcomes inform design intervention strategies factors affecting retention adherence among persons hiv include patient predisposing factors eg mental illness substance abuse patientenabling factors eg social support reminder strategies medication characteristics transportation housing insurance healthcare environment factors eg pharmacy services clinic experiences provider characteristics evidencebased recommendations improving retention adherence include 1 systematic monitoring clinic attendance art adherence 2 use peer paraprofessional navigators reengage patients care help remain care 3 optimization art regimens pharmaceutical supply chain management systems 4 provision reminder devices tools 5 general education counseling 6 engagement peer family community support groups 7 case management 8 targeting patients substance abuse mental illness research needed effective monitoring strategies interventions focus improving retention adherence specific attention healthcare environment