Evidence map›Paper›PMID 40773004›Full record

ReviewCurrent HIV/AIDS reports2025

Social and Structural Interventions to Reduce Strikingly High Post-Hospital Mortality for People Living with HIV in Sub-Saharan Africa.

Cassidy W Claassen, Tonderai Mabuto, Kate Shearer, Jane Park, Megan Willkens, Chiti Bwalya, Benson Issarow, Cecilia Kanyama, Rob N Peck, Michael Vinikoor and 1 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Current HIV/AIDS reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Cassidy W ClaassenCenter for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD, USA. cclaassen@ihv.umaryland.edu.ORCID http://orcid.org/0000-0001-5059-7894
Tonderai MabutoThe Aurum Institute, Johannesburg, South Africa.
Kate ShearerDivision of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.ORCID http://orcid.org/0000-0003-2049-4258
Jane ParkCenter for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD, USA.
Megan WillkensCenter for Global Health, Weill Cornell Medicine, New York, NY, USA.ORCID http://orcid.org/0009-0003-8184-1302
Chiti BwalyaMaryland Global Initiatives, Lusaka, Zambia.ORCID http://orcid.org/0000-0002-6110-0019
Benson IssarowMwanza Intervention Trials Unit, Mwanza, Tanzania.
Cecilia KanyamaUniversity of North Carolina Project, Lilongwe, Malawi.ORCID http://orcid.org/0000-0001-8673-3763
Rob N PeckCenter for Global Health, Weill Cornell Medicine, New York, NY, USA.ORCID http://orcid.org/0000-0002-4526-2480
Michael VinikoorUniversity of Alabama Birmingham School of Medicine, Birmingham, AL, USA.
Christopher J HoffmannDivision of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-9422-0519

Funding

Reducing Post-Hospital Mortality in HIV-Infected Adults in TanzaniaR01MH118107 · NIMH · WEILL MEDICAL COLL OF CORNELL UNIV · PI PECK, ROBERT N · 2018 to 2022
$2.7M
ZENITH D43 HIV & Aging Supplement - Prevalence of aging related conditions, stigma, and quality of life among older adults with and without HIV infection in ZambiaD43TW012493 · FIC · UNIVERSITY OF MARYLAND BALTIMORE · PI Cassidy W. Claassen, Lloyd Berdard Mulenga · 2023 to 2026
$1.3M
Home link: Post hospital care to reduce HIV mortality in South AfricaR34MH118998 · NIMH · JOHNS HOPKINS UNIVERSITY · PI HOFFMANN, CHRISTOPHER J · 2019 to 2021
$625k
Re-engagement at Discharge (Re-Charge): Improving post-hospital outcomes for HIV-infected adults in ZambiaR34MH122265 · NIMH · UNIVERSITY OF MARYLAND BALTIMORE · PI CLAASSEN, CASSIDY W., VINIKOOR, MICHAEL JEFFREY · 2021 to 2023
$594k
FIC NIH HHS D43 TW012493National Institute of Mental Health, NIH R01MH118107National Institute of Mental Health, NIH R34MH118998National Institute of Mental Health, NIH R34MH122265NIMH NIH HHS R34 MH122265
6 · The paper itself

Abstract

purpose of reviewDeath following hospitalization remains strikingly high for people living with HIV (PLHIV) in sub-Saharan Africa. Hospitalization represents a key opportunity for targeted interventions, yet evidence for effective approaches remains limited. We conducted a best-evidence narrative review, framed by the Andersen Model of Health Care Utilization, to examine factors contributing to post-hospital mortality and assess recent interventions. RECENT

findingsPLHIV in sub-Saharan Africa have a 12-26% risk of death within 3-6 months of discharge. Social and structural barriers-including poverty, stigma, food insecurity, and low self-efficacy-are central mediating factors. We reviewed three disease-neutral interventions (HomeLink, Daraja, ReCharge) providing home-based support, counseling, and care linkage. While feasible and acceptable, mortality impact was mixed due to small sample sizes and advanced illness. The hospital-to-home transition is a critical window for intensified differentiated services to reduce mortality among PLHIV. Further research is needed to define scalable and cost-effective models to improve survival and close gaps in HIV care.

Indexed as

HIV InfectionsHospitalizationAfrica South of the SaharaHumansSocial StigmaDifferentiated service deliveryEngagement in careHIV epidemic controlPost-hospital mortalitySub-Saharan AfricaTransitions of care

Identifiers

PMID40773004
PMCPMC12961755

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.