title: Linkage, initiation and retention of children in the antiretroviral therapy cascade: an overview.
abstract: In 2012, there were an estimated 2 million children in need of antiretroviral therapy (ART) in the world, but ART is still reaching fewer than 3 in 10 children in need of treatment. [1, 7] As more HIV-infected children are identi&filig;ed early and universal treatment is initiated in children under 5 regardless of CD4, the success of pediatric HIV programs will depend on our ability to link children into care and treatment programs, and retain them in those services over time. In this review, we summarize key individual, institutional, and systems barriers to diagnosing children with HIV, linking them to care and treatment, and reducing loss to follow-up (LTFU). We also explore how linkage and retention can be optimally measured so as to maximize the impact of available pediatric HIV care and treatment services.
authors.affiliation: aUnited States Agency for International Development, Washington, District of Columbia bBaylor College of Medicine, Houston, Texas cUnited States Agency for International Development, Washington, District of Columbia dCenters for Disease Control and Prevention, Atlanta, Georgia eManagement Sciences for Health, Washington, District of Columbia fBaylor College of Medicine, Houston, Texas gClinton Health Access Initiative, New York, New York hLiverpool School of Tropical Medicine, UK. *B. Ryan Phelps, Saeed Ahmed, Anouk Amzel, Mamadou O. Diallo, Troy Jacobs, Scott E. Kellerman, Maria H. Kim, Nandita Sugandhi, and Melanie Tam contributed equally to the writing of the article.
authors.forename: B Ryan
authors.initials: BR
authors.lastname: Phelps
authors.forename: Saeed
authors.initials: S
authors.lastname: Ahmed
authors.forename: Anouk
authors.initials: A
authors.lastname: Amzel
authors.forename: Mamadou O
authors.initials: MO
authors.lastname: Diallo
authors.forename: Troy
authors.initials: T
authors.lastname: Jacobs
authors.forename: Scott E
authors.initials: SE
authors.lastname: Kellerman
authors.forename: Maria H
authors.initials: MH
authors.lastname: Kim
authors.forename: Nandita
authors.initials: N
authors.lastname: Sugandhi
authors.forename: Melanie
authors.initials: M
authors.lastname: Tam
authors.forename: Megan
authors.initials: M
authors.lastname: Wilson-Jones
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D002675:Child, Preschool; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy*; D006293:Health Promotion / Q000379:methods; D054625:Healthcare Disparities / Q000592:standards; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008134:Long-Term Care / Q000592:standards*; D059012:Lost to Follow-Up; D010349:Patient Compliance; D014944:World Health Organization
chemical_list: D019380:Anti-HIV Agents; D044966:Anti-Retroviral Agents