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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.
Activities
Infants, children, and adolescents
- Active Pediatric HIV Case Finding in Kenya and Uganda
- Assessing the Feasibility, Acceptability, and Costs of Diagnosing HIV at Birth in Lesotho and Rwanda
- Effect of a Family-centered Model of HIV Care on Viral Suppression and Care Retention Among HIV-positive Children in Swaziland
- Effectiveness of a Pediatric HIV Disclosure Intervention in Uganda
- Evaluation of “One Community” in Malawi
- Evaluating a Multidisciplinary Integrated Management Team Intervention to Improve Maternal-child Outcomes and HIV Service Uptake and Retention in Lesotho
- Evaluating Community-facility Linkage Models to Promote Mother-infant Retention Along the HIV Care Continuum
- Project YES! Youth Engaging for Success: A peer mentoring program to transition youth to HIV self-management in Zambia
- Strengthening Community-based Services for Children and Families Affected by HIV: An evaluation of the Zambia Family (ZAMFAM) Program
Adults
- A Systems Approach to Improving Delivery and Uptake of Facility-based HIV Testing and Linkage to Care in South Africa
- Assessing HIV-related Outcomes, Cost, and Misclassification Rates among Key Populations Accessing Community-based Test and Start Services in Nigeria
- Assessment of the Implementation of the Treat-all Guidelines (Test and Start) in Namibia
- Evaluating a Multidisciplinary Integrated Management Team Intervention to Improve Maternal-Child Outcomes and HIV Service Uptake and Retention in Lesotho
- Evaluating Community-facility Linkage Models to Promote Mother-infant Retention Along the HIV Care Continuum
- Impact of a Community-based, HIV Intervention on Antiretroviral Treatment Retention and Adherence in Tanzania
- Improving Uptake of HIV Testing Services and Linkages to Care after Diagnosis in Kenya
- Optimizing Community Services for an Improved Continuum of HIV Care in South Africa
- Optimizing Implementation of Universal HIV Treatment Coverage for People Living with HIV in Senegal
- Treating Depression to Improve HIV Care Outcomes in Malawi