title: Guidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: evidence-based recommendations from an International Association of Physicians in AIDS Care panel.
abstract: METHODS
  After HIV diagnosis, timely entry into HIV medical care and retention in that care are essential to the provision of effective antiretroviral therapy (ART). Adherence to ART is among the key determinants of successful HIV treatment outcome and is essential to minimize the emergence of drug resistance. The International Association of Physicians in AIDS Care convened a panel to develop evidence-based recommendations to optimize entry into and retention in care and ART adherence for people with HIV.
  
  
  METHODS
  A systematic literature search was conducted to produce an evidence base restricted to randomized, controlled trials and observational studies with comparators that had at least 1 measured biological or behavioral end point. A total of 325 studies met the criteria. Two reviewers independently extracted and coded data from each study using a standardized data extraction form. Panel members drafted recommendations based on the body of evidence for each method or intervention and then graded the overall quality of the body of evidence and the strength for each recommendation.
  
  
  CONCLUSIONS
  Recommendations are provided for monitoring entry into and retention in care, interventions to improve entry and retention, and monitoring of and interventions to improve ART adherence. Recommendations cover ART strategies, adherence tools, education and counseling, and health system and service delivery interventions. In addition, they cover specific issues pertaining to pregnant women, incarcerated individuals, homeless and marginally housed individuals, and children and adolescents, as well as substance use and mental health disorders. Recommendations for future research in all areas are also provided.
authors.affiliation: AIDS Research Consortium of Atlanta, Atlanta, GA 30308, USA.
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Thompson
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mugavero
authors.forename: K Rivet
authors.initials: KR
authors.lastname: Amico
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Cargill
authors.forename: Larry W
authors.initials: LW
authors.lastname: Chang
authors.forename: Robert
authors.initials: R
authors.lastname: Gross
authors.forename: Catherine
authors.initials: C
authors.lastname: Orrell
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Altice
authors.forename: David R
authors.initials: DR
authors.lastname: Bangsberg
authors.forename: John G
authors.initials: JG
authors.lastname: Bartlett
authors.forename: Curt G
authors.initials: CG
authors.lastname: Beckwith
authors.forename: Nadia
authors.initials: N
authors.lastname: Dowshen
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Gordon
authors.forename: Tim
authors.initials: T
authors.lastname: Horn
authors.forename: Princy
authors.initials: P
authors.lastname: Kumar
authors.forename: James D
authors.initials: JD
authors.lastname: Scott
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stirratt
authors.forename: Robert H
authors.initials: RH
authors.lastname: Remien
authors.forename: Jane M
authors.initials: JM
authors.lastname: Simoni
authors.forename: Jean B
authors.initials: JB
authors.lastname: Nachega
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D035843:Biomedical Research; D019090:Case Management / Q000592:standards*; D003376:Counseling; D003695:Delivery of Health Care; D019317:Evidence-Based Medicine; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D055118:Medication Adherence; D008991:Monitoring, Physiologic; D010353:Patient Education as Topic; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D017010:Reminder Systems
chemical_list: D019380:Anti-HIV Agents