Disparities in Retention in Care Among Adults Living with HIV/AIDS: A Systematic Review
As national HIV prevention goals aim to increase the proportion of persons living with HIV, determining existing disparities in retention in care will allow for targeted intervention. The purpose of this systematic review was to identify existing disparities in retention in care. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 guided this systematic review. Electronic databases, including PubMed/MEDLINE, CINAHL, Sociological Collection, PsychInfo, and Cab Direct/Global Health, were systematically searched and twenty studies were included. This review identified disparities in retention in care that have been documented by race, gender, age, HIV exposure, incarceration history, place of birth, and U.S. geographic location. Research is necessary to further identify existing disparities in retention in care and to better understand determinants of health disparities. Additionally, interventions must be tailored to meet the needs of health disparate populations and should be assessed to determine their effectiveness in reducing health disparities.
KeywordsHIV Retention in care Health disparity Disparities
Thank you to Sharon Leslie, Nursing Informationist at Emory University, for her input on the final search strategy, as well as Lilian Takahashi Hoffecker, Research Librarian at University of Colorado, for her review of the systematic review protocol’s methodology.
This study was funded by the National Institute of Nursing Research and the National Institute of Mental Health of the National Institutes of Health under the following award numbers: F31 NR017580 (Principle Investigator [PI]: Ashley N. Anderson), R01 MH092284 (PI: Drenna Waldrop-Valverde), P30 NR014134 (PI: Drenna Waldrop-Valverde), T32NR012715 (PI: Sandra Dunbar).
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
- 1.Centers for Disease Control and Prevention (2017) Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas. HIV Surveillance Supplemental Report 2019, 24(3)Google Scholar
- 2.The White House (2016) National HIV/AIDS strategy for the United States: updated to 2020Google Scholar
- 8.Williams MB, Mitchell F, Thomson GE. Examining the health disparities research plan of the National Institutes of Health: unfinished business. Washington: National Academies Press; 2006.Google Scholar
- 9.Steele CB, Melendez-Morales L, Campoluci R, DeLuca N, Dean HD (2007) Health disparities in HIV/AIDS, viral hepatitis, sexually transmitted diseases, and tuberculosis: issues, burden, and response, a retrospective review 2000–2004. Centers for Diseaes Control and PreventionGoogle Scholar
- 12.Keppel K, Pamuk E, Lynch J, Carter-Pokras O, Kim I, Mays V, et al. Methodological issues in measuring health disparities. Vital Health Stat. 2005;141:1–16.Google Scholar
- 15.Clarivate Analytics. Endnote X8.1. Clarivate Analytics; 2017.Google Scholar
- 16.Veritas Health Innovation Ltd. Covidence systematic review software. Melbourne, Australia: Veritas Health Innovation; 2019.Google Scholar
- 17.Dang D, Dearholt S. Johns Hopkins nursing evidence-based practice: model and guidelines. 3rd ed. Indianapolis: Sigma Theta Tau Int; 2017.Google Scholar
- 18.Viswanathan M, Ansari MT, Berkman ND, Chang S, Hartling L, McPheeters M, et al. Assessing the risk of bias of individual studies in systematic reviews of health care interventions. Methods guide for effectiveness and comparative effectiveness reviews. Rockville: Agency for Healthcare Research and Quality; 2008.Google Scholar
- 19.Higgins JPT, Green S, editors. Cochrane handbook for systematic review of interventions. The Cochrane Collaboration. New Jersey: Wiley; 2011.Google Scholar
- 20.Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, et al. Guidance on the conduct of narrative synthesis in systematic reviews. 2006.Google Scholar
- 43.Lopez N, Gadseden VL (2016) Health inequalities, social determinants, and intersectionality. National Academy of Medicine Perspecitives.Google Scholar