ArticlePloS one2021
Improving the continuum of care monitoring in Brazilian HIV healthcare services: An implementation science approach.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Evaluation of health technology implementation in the Brazilian public health system: a systematic review.BMC health services research · 2025Pooled it
- Implementation of Multifaceted Enhanced School-located Influenza Vaccination Strategies in China: A Mixed Methods Evaluation Using the RE-AIM Framework and Normalization Process Theory.International journal of behavioral medicine · 2026Article
- Evaluating the contribution of operation triple zero to HIV viral load suppression and retention among the adolescents in TASO Uganda using RE-AIM framework: a before and after implementation science study.AIDS research and therapy · 2025Article
- HIV Care Seeking Pathways and Barriers to the Continuum of Care Faced by Persons Living With HIV in Rural Nepal: A Qualitative Study.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- Factors associated with the interruption of antiretroviral therapy among people living with HIV/AIDS in Brazilian municipalities between 2019 and 2022.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2025Article
- Improving retention and HIV viral load suppression among adolescents living with HIV in TASO Soroti and TASO Mbale centers of excellence using Operation Triple Zero model: a before and after study protocol.Implementation science communications · 2023Article
- Profile of the cohort of people being treated for HIV infection in the SUS, Brazil, 2015-2018.Revista de saude publica · 2023Article
Corrections and comments
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Authors and funding
17 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the impact of an intervention improving the continuum of care monitoring (CCM) within HIV public healthcare services in São Paulo, Brazil, and implementing a clinical monitoring system. This system identified three patient groups prioritized for additional care engagement: (1) individuals diagnosed with HIV, but not receiving treatment (the treatment gap group); (2) individuals receiving treatment for >6 months with a detectable viral load (the virologic failure group); and (3) patients lost to follow-up (LTFU).
methodsThe implementation strategies included three training sessions, covering system logistics, case discussions, and development of maintenance goals. These strategies were conducted within 30 HIV public healthcare services (May 2019 to April 2020). After each training session, professionals shared their experiences with CCM at regional meetings. Before and after the intervention, providers were invited to answer 23 items from the normalization process theory questionnaire (online) to understand contextual factors. The mean item scores were compared using the Mann-Whitney U test. The RE-AIM implementation science framework (evaluating reach, effectiveness, adoption, implementation, and maintenance) was used to evaluate the integration of the CCM.
resultsIn the study, 47 (19.3%) of 243 patients with a treatment gap initiated treatment, 456 (49.1%) of 928 patients with virologic failure achieved suppression, and 700 of 1552 (45.1%) LTFU patients restarted treatment. Strategies for the search and reengagement of patients were developed and shared. Providers recognized the positive effects of CCM on their work and how it modified existing activities (3.7 vs. 4.4, p<0.0001, and 3.9 vs. 4.1, p<0.05); 27 (90%) centers developed plans to sustain routine CCM.
conclusionImplementing CCM helped identify patients requiring more intensive attention. This intervention led to changes in providers' perceptions of CCM and care and management processes, which increased the number of patients engaged across the care continuum and improved outcomes.
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