Less than a third of patients who test HIV positive are successfully linked to and retained in care within one year in sub-Saharan Africa, a startling statistic given that sustained care is essential to treating the disease and preventing further transmission. Significant scale-up of HIV services has resulted in nearly 13 million individuals receiving HIV care and support and more than 3.9 million initiating antiretroviral therapy (ART), however linkage and retention of patients remains a challenge for national HIV programs.
While most studies examining approaches to improving linkage and retention have evaluated one intervention that targets a single step in the HIV care continuum from diagnosis to care and eventual treatment, ICAP will conduct a new study over the next three years that bundles several strategies together.
Funded by the United States Agency for International Development (USAID), the study called Engage4Health, one of several implementation science studies to be initiated by ICAP in collaboration with partners in-country, will combine several interventions targeting individuals newly diagnosed with HIV in urban and rural settings in Mozambique, a poor nation with an estimated 1.7 million people living with HIV. The study will assess a combination of evidence-based strategies such as testing a patient’s viral load at HIV testing sites, initiating treatment early for eligible patients, and sending text-messaged appointment reminders.
ICAP has partnered with Mozambique since 2004 to provide technical assistance and financial support for the scale-up of HIV prevention, care, and treatment services funded by the US Presidential Emergency Fund for AIDS Relief (PEPFAR). The design and implementation of this study centers on long-standing collaborations across the United States and Mozambique, spanning academia, government, and the NGO sector. Collaborating institutions in Mozambique include the Ministry of Health, the National Institute of Health, Eduardo Mondlane University, and the Center for Collaboration in Health, an indigenous NGO.
Based upon the aims for improved HIV treatment coverage in the Mozambican National HIV/AIDS Strategic Plan for 2010-14, Engage4Health will form part of a growing body of knowledge achieved through harmonized implementation research. Findings from the study will be translated into applications for HIV programs across Mozambique and other resource-limited settings, and shared widely locally and internationally. Engage4Health also aims to build local capacity for research through trainings, mentorship, and research and clinical seminars.