A multidisciplinary approach to people living with HIV dropping out from and returning to treatment - results from a HIV Clinic in Portugal

Abstract

Background: Adherence to HIV care is pivotal for achieving viral suppression, preventing viral transmission, and improving health outcomes. Despite advancements in antiretroviral therapy, many people living with HIV (PLHIV) are disengaged from care, compromising treatment effectiveness. Methods: A retrospective cohort study was conducted on 81 episodes of care dropout at a Portuguese hospital between 2018 and 2024. A multidisciplinary team (physicians, nurses, social workers, and mental health professionals) implemented a structured program to reengage patients. Demographic, clinical, and socioeconomic data were collected at baseline and after six months. Results: 79% percent of the participants returned to care, with 68% resuming antiretroviral therapy. Although most patients achieved improved viral load suppression after returning, 27% were lost to follow-up after six months. Foreign-born individuals were associated with a lower likelihood of re-engagement. Common barriers include financial hardship, limited social support, and unaddressed mental health needs. Conclusions: A multidisciplinary approach effectively reconnected PLHIV to care and achieved enhanced virological outcomes. However, persistent socioeconomic and psychosocial challenges can lead to repeated disengagement. Long-term, targeted interventions, particularly for vulnerable groups, are required to sustain retention and ensure improved HIV management and overall patient well-being.