Effect of a person-centered care intervention on return and sustained reengagement after treatment interruptions from HIV care in Zambia: A post-hoc analysis of a stepped-wedged cluster randomized trial.

TL;DR

A person-centered care intervention targeting healthcare worker behavior and client experience in 24 Zambian HIV clinics increased return to care after treatment interruptions (72.3% vs 67.7%) and sustained retention among returners (82.7% vs 73.4% remaining in care at 12 months). Overall, the intervention increased the proportion in care 12 months after a treatment interruption from 51.5% to 60.1%.

Key findings

• Person-centered care intervention included HCW training/coaching, client experience feedback via exit interviews, and facility-level incentives
• Among 128,910 clients with treatment interruptions (>30 days late), intervention increased return incidence at 12 months (adjusted HR 1.16, p<0.001)
• Among those who returned, intervention decreased repeat treatment interruptions (44.3% vs 55.6%, adjusted HR 0.50, p<0.001)
• Overall retention benefit persisted: 60.1% in care 12 months post-interruption with intervention vs 51.5% in control (adjusted RR 1.19, p=0.008)

Why this matters at the bedside

Demonstrates that improving healthcare worker caring behaviors and patient experience can effectively address the persistent clinical challenge of treatment interruptions and reengagement in HIV care, with meaningful improvements in retention metrics relevant to sustained viral suppression and public health outcomes.