Case Management Intervention Improves HIV Clients' Retention in Care

Background

One of the challenges in the HIV management program is retaining people living with HIV (PLHIV) in care. To increase retention in our ART cohorts, we implemented a case management intervention using a risk stratification tool (RST) to enroll four categories of PLHIV:

• Defaulters brought back to care (DBB2C)
• Clients with high viral load (HVL)
• Clients initiated on ART for the first time (FT)
• Clients who declined same-day initiation (CDSA)

This study presents data from eight districts in Malawi collected from January to September 2022.

Methods

We trained expert clients (EC) and treatment supporters (TS) to work as case managers. Using the RST:

• Low risk (LR) clients were managed by ECs
• Moderate-risk (MR) and high-risk (HR) clients were managed by TS

Data was collected during each client encounter and documented in registers. A descriptive analysis was conducted on this programmatic data.

Results

Conclusion

The findings demonstrate that case management with risk stratification and peer-delivered counseling significantly improves retention across different client categories. The intervention was particularly effective for defaulters brought back to care (100% retention) and clients with high viral load (97% retention). This approach provides a scalable model for improving HIV care continuity in resource-limited settings.