WHAT IS THE PROBLEM?
Loss at each step of the HIV diagnostic and treatment cascade has been well documented. Many newly-identified HIV-positive persons fail to link/enroll in care and initiate treatment, and those on antiretroviral treatment (ART) often miss appointments and fail to return to care/treatment. Addressing poor linkage and retention is critical for epidemic control. Successful tracking and tracing of people living with HIV (PLHIV) who have failed to initiate treatment or failed to return to care/treatment will allow targeted interventions to help return those patients back to treatment, document their treatment in another setting, or document their death or lost to follow up (LTFU).
WHAT IS THE TOOL?
Identifying and locating PLHIV who fail to link to care and initiate ART or who fail to be retained in care/on treatment are important interventions to ensure all HIV-positive patients get on and remain on ART. This tool outlines procedures for tracking and tracing PLHIV who have failed to link or who have missed appointments/are LTFU. Procedures for identifying, following non-linkers and those not in care/on treatment through phone and home contacts, and documenting outcomes are outlined. Individual level follow-up allows for targeted support to HIV-positive persons needing to (re-)enter care and treatment. In addition, documentation of individual outcomes is necessary to obtain accurate numbers of patients who are actually not in care and on treatment and the outcomes of those LTFU including silent transfers to other clinics, death, those who are unable to be located, not traced, or returned to care/clinic. These outcomes are required for the MER Indicator TX_ML. Best practice procedures for phone and home contacts are provided, as well as sample tools from partners for recording tracking and tracing activities.