ArticleAIDS research and therapy2026
Strategies to improve retention in care among people living with HIV at health facilities in Manaus, Brazil: insight from health care providers.
Article in AIDS research and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Cost-effectiveness of differentiated HIV service delivery in North Wollo, Ethiopia: a retrospective study.BMJ open · 2026Article
- HIV/AIDS in the state of Amazonas, Brazilian Amazon: decentralization, third-party support and community action.Revista da Sociedade Brasileira de Medicina Tropical · 2026Review
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5 authors.
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Abstract
backgroundRetention in HIV care is a key component of the continuum of care and is essential for achieving the UNAIDS 95-95-95 targets. In Manaus, Northern Brazil, despite advances in HIV treatment and prevention, loss to follow-up among PLHIV remains a significant barrier to viral suppression and epidemic control. The present research explored health care providers' perspectives on strategies to improve retention in care among people living with HIV (PLHIV) at referral health facilities in Manaus.
methodsA qualitative cross-sectional study was conducted between November 2023 and October 2025 in six public health facilities in Manaus. Semi-structured, in-depth interviews were performed with 56 health care providers, including physicians, nurses, social workers, psychologists, pharmacists, and HIV/AIDS program state managers. Data were analyzed using thematic framework analysis with MAXQDA software.
resultsSix major themes emerged from the analysis: (1) monitoring and follow-up of PLHIV, (2) challenges related to loss to follow-up, (3) impact of loss to follow-up on UNAIDS 95-95-95 goals, (4) barriers to retention, (5) strategies to optimize retention, and (6) state-level initiatives to improve retention. Providers identified poverty, food insecurity, unemployment, stigma, discrimination, transportation barriers, substance use, and health system constraints such as workforce shortages, long waiting times, and lack of privacy as key drivers of disengagement. Proposed strategies included strengthening multidisciplinary teams, promoting continuous professional training, implementing patient-centered and stigma-free care, enhancing active patient tracing, expanding digital communication tools, decentralizing services, and ensuring adequate financial and human resources.
conclusionsRetention in HIV care in Manaus is shaped by complex social and systemic factors. Integrated, multisectoral strategies addressing socioeconomic vulnerabilities and service-level barriers are essential to improve long-term engagement in care and advance progress toward the UNAIDS 95-95-95 targets.
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