Evidence map›Paper›PMID 41474019›Full record

ArticleHIV medicine2026

Supporting long-term engagement in HIV clinical care: Learning from the COVID-19 pandemic.

R Dhairyawan, Sara Paparini, M Smuk, S Sidat, R Mbewe, Silvia Petretti, V Martin, S Dakshina, H Alexander, T D Appleby and 10 more

Abstract read
In one paragraph

Article in HIV medicine, 2026. 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

20 authors.

R DhairyawanSHARE Collaborative, Blizard Institute, Queen Mary University of London, London, UK.ORCID https://orcid.org/0000-0002-3230-758X
Sara PapariniSHARE Collaborative, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.ORCID https://orcid.org/0000-0002-1909-2481
M SmukSHARE Collaborative, Blizard Institute, Queen Mary University of London, London, UK.
S SidatSHARE Collaborative, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
R MbeweSHARE Collaborative, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Silvia PetrettiPositively UK, London, UK.
V MartinBlood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, UK Health Security Agency, London, UK.ORCID https://orcid.org/0000-0002-0570-095X
S DakshinaBarts Health NHS Trust, London, UK.ORCID https://orcid.org/0000-0002-8965-4400
H AlexanderNorth Middlesex University Hospital, London, UK.
T D ApplebyLewisham and Greenwich NHS Trust, London, UK.
K ChildsKing's College Hospital NHS Foundation Trust, London, UK.
M BracchiChelsea and Westminster Hospital NHS Foundation Trust, London, UK.
B DragovicSt George's University Hospital NHS Foundation Trust, London, UK.
G HaidariGuy's and St Thomas' NHS Foundation Trust, London, UK.
N MackieImperial College Healthcare NHS Trust, London, UK.
I ReevesHomerton Healthcare NHS Trust, London, UK.
A UmaipalanBarking, Havering and Redbridge University Hospitals NHS Trust, London, UK.
L J WatersCentral North West London NHS Trust, London, UK.ORCID https://orcid.org/0000-0002-1379-1775
J AndersonBarts Health NHS Trust, London, UK.ORCID https://orcid.org/0000-0001-5294-8707
C M OrkinSHARE Collaborative, Blizard Institute, Queen Mary University of London, London, UK.ORCID https://orcid.org/0000-0001-6168-6745

Funding

Barts Charity MGU0574
6 · The paper itself

Abstract

objectivesSHIELD is a London-based study of engagement in HIV clinical care during and after the COVID-19 pandemic. We document the characteristics of service users who either re-engaged or disengaged with HIV care, together with reflections of HIV clinical service-providers to inform recommendations that address care retention for the long term.

methodsUsing an exploratory mixed methods approach, service-users aged ≥18 years who re-engaged (1 March 2020-31 August 2020) or disengaged from clinical care (no contact with service 1 March 2020-28 February 2021) at 8 London HIV services were identified by retrospective records review. Demographics and clinical data were summarized descriptively. For people who re-engaged, follow-up data were collected at 24 months and in those who disengaged, at a single timepoint (1 March 2023). Semi-structured interviews with clinic staff were analysed thematically.

resultsThere were 122 people disengaged and 89 re-engaged. In those who re-engaged, a 24-month follow-up showed 71.3% on antiretrovirals, 63.6% virally suppressed and 67.9% had a future clinician appointment booked. For people who disengaged, by 1 March 2023, 21% were on antiretrovirals and 27% had a future appointment booked. Interviews with 11 service providers explored COVID-19's impact on clinical services, multilevel interactions that influenced engagement, and approaches to re-engaging people.

conclusionsWe found that COVID-19 exposed existing vulnerabilities deterring access to HIV clinical care, as well as being itself an additional factor. For some people, the pandemic provided an opportunity to re-engage. We recommend that retention in care is prioritized in policy and financially, that clinical services provide holistic person-centred care, and improve ways to identify those who leave care.

Indexed as

COVID-19HIV InfectionsRetention in CareAdultFemaleHumansLondonMaleMiddle AgedRetrospective StudiesSARS-CoV-2Young AdultcascadeCOVID‐19engagementHIVretention

Identifiers

PMID41474019
PMCPMC13140006

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

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.