Nominated From: University of Washington
Research Site: Peru
Research Area: Infectious Disease
Primary Mentor: Eduardo Gotuzzo
Identifying Risk Groups for Low Retention in Care among People Living With HIV in Peru
Retention in the cascade of HIV care is associated with favorable health outcomes but remains a challenge worldwide despite accessible antiretroviral therapy (ART)(1,2). Low retention in care of People Living with HIV (PLWH) results in reduced viral suppression, increased transmissibility, and additional programmatic hardships including higher rates of HIV resistance to first-line regimens(3,4). Therefore, HIV programs, particularly in low-resource settings, should actively improve retention in care in order to maximize the individual and public- health benefits of HIV care(4).
Under the cascade of care framework, there is a need for programmatic interventions that should be tailored to groups at risk of lower retention rates(5,6,7). Consequently, HIV programs should accurately identify such target groups(8). Whereas social and structural determinants such as unstable housing, unemployment, mental health and/or substance use disorders are commonplace among PLWH(9), the NHP in Peru lacks yet of quality and thoroughly assessed information on the specific social risk factors of HIV patients enrolled and how those factors impact on negative outcomes including poor retention(5,9).
The need to design and scale-up effective programmatic strategies for retention in care is reinforced at a time when already-challenged HIV programs struggle to respond to the recent expansion of ART eligibility criteria(10). Therefore, I propose to develop, validate, and apply an instrument to identify risk groups for low retention in care of PLWH at the National HIV Program in Peru. This corresponds to the first step in the process of the implementation of a programmatic-tailored intervention to improve retention in care of PLWH in Peru and similar settings.
- To develop and validate an instrument to identify groups with social and structural risk factors for low retention in care at the National HIV Program (NHP) in Peru.
- To pilot test this instrument among PLWH enrolled at two NHP facilities in coastal Peru.
Knowing the impact of the most common mental illnesses such as anxiety and depressive symptoms as well as their associated factors in a Quechua-speaking population will facilitate the development of culturally and linguistically appropriate intervention strategies, which can be used as a model in other regions with similar contexts, in both Peru and other native communities abroad. There are strong community ties and enthusiastic local support for the execution of this project by the research team and for collaboration in the development of future interventions.
- Eduardo Gotuzzo, Universidad Peruana Cayetano Heredia
- Joseph Zunt, University of Washington
- Larissa Otero, Universidad Peruana Cayetano Heredia