ArticlePLOS global public health2024
Re-engagement and retention in HIV care after preventive default tracking in a cohort of HIV-infected patients in rural Malawi: A mixed-methods study.
Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review and meta-analysis of retention and disengagement after initiation on antiretroviral therapy in low- and middle-income countries after the introduction of Universal Test and Treat policies.Journal of the International AIDS Society · 2025Pooled it
- NCD-SCAN: A Digital Health Tool for Community-Based Non-Communicable Disease Risk Screening by Lady Health Workers in Pakistan.Research square · 2026Article
- Strategies to improve retention in care among people living with HIV at health facilities in Manaus, Brazil: insight from health care providers.AIDS research and therapy · 2026Article
- Progress of HIV care cascade and transition dynamics along the continuum of care among persons living with HIV in Ifakara, Tanzania: a prospective study.BMC infectious diseases · 2026Article
- Applying Machine Learning to Predict Loss to Follow-Up Among People Living With HIV in Haiti Using a National Electronic Medical Record Cohort.International journal of public health · 2026Article
- Spatial modeling of HIV prevalence in Malawi using generalized additive models.Frontiers in epidemiology · 2026Article
- Who does tracing work for? Characteristics of clients successfully re-engaged in ART care in sub-Saharan Africa after a tracing intervention: A systematic review.PLOS global public health · 2026Article
- Advanced HIV disease management and patient outcomes in rural setting - Malawi: a retrospective cohort study.AIDS research and therapy · 2025Article
- Clinical outcomes in the era of test and treat among children living with HIV: a retrospective before/after study in Zambia.Frontiers in pediatrics · 2025Article
- Article
- Considerable variation in the 95-95-95 targets accomplishment between children and adults might delay achievement of set targets.Frontiers in public health · 2025Review
- Tracking People Living with HIV in Loss to Follow Up in Central Brazil: A Call for Attention to Health Services.AIDS and behavior · 2024Article
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Authors and funding
11 authors.
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Abstract
Loss-to-follow-up (LTFU) in the era of test-and-treat remains a universal challenge, especially in rural areas. To mitigate LTFU, the HIV program in Neno District, Malawi, utilizes a preventive default tracking strategy named Tracking for Retention and Client Enrollment (TRACE). We utilized a mixed-methods descriptive study of the TRACE program on patient's re-engagement and retention in care (RiC). In the quantitative arm, we utilized secondary data of HIV-infected patients in the TRACE program from January 2018 to June 2019 and analyzed patients' outcomes at 6-, 12-, and 24-months post-tracking. In the qualitative arm, we analyzed primary data from 25 semi-structured interviews. For the study period, 1028 patients were eligible with median age was 30 years, and 52% were women. We found that after tracking, 982 (96%) of patients with a 6-week missed appointment returned to care. After returning to care, 906 (88%), 864 (84%), and 839 (82%) were retained in care respectively at 6-,12-, and 24-months. In the multivariate analysis, which included all the covariates from the univariate analysis (including gender, BMI, age, and the timing of ART initiation), the results showed that RiC at 6 months was linked to WHO stage IV at the start of treatment (with an adjusted odds ratio (aOR) of 0.18; 95% confidence interval (CI) of 0.06-0.54) and commencing ART after the test-and-treat recommendation (aOR of 0.08; 95% CI: 0.06-0.18). RiC after 12 months was associated with age between 15 and 29 years (aOR = 0.18; 95%CI: 0.03-0.88), WHO stage IV (aOR = 0.12; 95%CI: 0.04-0.16) and initiating ART after test-and-treat recommendations (aOR = 0.08; 95%CI: 0.04-0.16). RiC at 24 months post-tracking was associated with being male (aOR = 0.61; 95%CI: 0.40-0.92) and initiating ART after test-and-treat recommendations (aOR = 0.16; 95%CI:0.10-0.25). The qualitative analysis revealed that clarity of the visit's purpose, TRACE's caring approach changed patient's mindset, enhanced sense of responsibility and motivated patients to resume care. We recommend integrating tracking programs in HIV care as it led to increase patient follow up and patient behavior change.
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