2026-07-21T17:55:56Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/86252025-04-10T09:29:42Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19608

00925njm 22002777a 4500 dc Fuente-Soro, Laura author Iniesta-Marmol, Carlos author López-Varela, Elisa author Cuna, Mauro author Guilaze, Rui author Maixenchs, Maria author Bernardo, Edson Luis author Augusto, Orvalho author González, Raquel author Couto, Aleny author Munguambe, Khatia author Naniche, Denise author 2019 BACKGROUND: The implementation of quality HIV control programs is crucial for the achievement of the UNAIDS 90-90-90 targets and to motivate people living with HIV (PLWHIV) to link and remain in HIV-care. The aim of this mixed method cross-sectional study was to estimate the linkage and long-term retention in care of PLWHIV and to identify factors potentially interfering along the HIV-care continuum in southern Mozambique. METHODS: A home-based semi-structured interview was conducted in 2015 to explore barriers and facilitators to the HIV-care cascade among individuals that had been newly HIV-diagnosed in community testing campaigns in 2010 or 2012. Linkage and long-term retention were estimated retrospectively through client self-reports and clinical records. Cohen's Kappa coefficient was calculated to measure the agreement between participant self-reported and documented cascade outcomes. RESULTS: Among the 112 interviewed participants, 24 (21.4%) did not disclose their HIV-positive serostatus to the interviewer. While 84 (75.0%) self-reported having enrolled in care, only 69 (61.6%) reported still being in-care 3-5 years after diagnosis of which 17.4% reported having disengaged and re-engaged. An important factor affecting optimal continuum in HIV-care was the impact of the fear-based authoritarian relationship between the health system and the patient that could act as both driver and barrier. CONCLUSION: Special attention should be given to quantify and understand repeated cycles of patient disengagement and re-engagement in HIV-care. Strategies to improve the relationship between the health system and patients are still needed in order to optimally engage PLWHIV for long-term periods. PLoS One. 2019 Sep 27;14(9):e0222028. 10.1371/journal.pone.0222028 1932-6203 1932-6203 PloS one 31560689 http://hdl.handle.net/20.500.12105/8625 Tipping the balance towards long-term retention in the HIV care cascade: A mixed methods study in southern Mozambique