How do we strengthen the continuum of care within health systems to improve treatment initiation, retention, and viral suppression?


The HIV care continuum (sometimes called the HIV treatment cascade) delineates the sequential steps or stages of health care that people living with HIV go through from getting tested, to entering and staying in care, to being prescribed antiretroviral therapy, and to adhering to treatment and achieving viral suppression. People living with HIV often face many hurdles–individual, relational, institutional–in following these steps, which health systems are becoming more cognizant of and more proactive in addressing.
Poor mental health and lack of social support are important barriers to consistent HIV care engagement and long-term viral suppression. Project SOAR is evaluating the integration of a depression management model into facility-based HIV care and also testing a toolkit to help adolescents better transition to self-management and adult care.
SOAR is also examining different approaches to strengthen the continuum of care, such as establishing community-facility linkages, instituting task shifting, and providing support services for a variety of populations including children and adolescents, men who have sex with men, sex workers, and the general adult population. Our portfolio includes three “test and start” studies (Senegal, Namibia, and Nigeria) that are looking at patient HIV outcomes as well as the relationship between HIV outcomes and how services are delivered in order to identify how best to optimize staffing, patient flow, and costs.


Infants, children, and adolescents