WHO launched today the policy brief Supporting Re-engagement in HIV Treatment Services addressing the urgent need to re-engage individuals in HIV treatment services, offering evidence-based strategies to overcome barriers, focusing on person-centered solutions and adaptable health programs. As countries strive towards the UNAIDS 95-95-95 targets, it's imperative to support re-engagement in HIV services, as disengagement from care can result in advanced HIV disease along with opportunistic infections, increased risk of mortality, higher rates of viral non-suppression and can drive development of drug resistance.
This policy brief highlights the multifaceted challenges of re-engaging individuals in HIV treatment services. It emphasizes person-centered interventions that address the root causes of disengagement and the importance of tailored support.
The brief highlights key WHO recommendations to support and sustain engagement of people living with HIV in treatment and care, including tracing approaches (e.g. phone, text messages, or home visits), adherence support (e.g. cognitive behavioural therapy, peer support and counselling), community-based interventions and the use of person-centered client data to monitor treatment.
The brief proposes a shift from merely increasing antiretroviral therapy (ART) access to ensuring sustained engagement in treatment and care, by improving the quality of HIV care. Key guiding principles include:
- welcoming, non-stigmatizing environment: creating a supportive atmosphere;
- adherence support: addressing challenges to maintain treatment;
- immediate treatment and care: rapid initiation and ongoing care;
- advanced HIV disease identification: early detection and intervention;
- equitable access: ensuring everyone receives necessary care; and
- community engagement: involving local communities in care efforts.
To define effective differentiated service delivery (DSD) pathways to support re-engagement in HIV treatment, the brief suggests practical approaches for sustainable engagement:
- clinical assessment and rapid ART reinitiation: immediate treatment and advanced disease management;
- psychosocial and adherence support: personalized support to overcome adherence challenges;
- addressing treatment interruptions: tailored pathways based on individual clinical needs; and
- population-specific considerations: addressing unique challenges of different populations.
Health policymakers, practitioners, and community leaders should consider prioritizing implementation of the strategies outlined in the WHO policy brief to enhance sustainability of HIV treatment programs and move closer to achieving the 95-95-95 targets. Collective action is crucial to ensure continuous, life-saving care for people living with HIV.
