Evidence mapPaperPMID 40424412Full record

ArticlePloS one2025

"If he returns, receive him because he has realized that he needs assistance": A qualitative study exploring preferences for retention on antiretroviral therapy support in Malawi among Lighthouse Clinic clients.

Gillian O'Bryan, Jacqueline Huwa, Odala Sande, Agness Thawani, Astrid Berner-Rodoreda, Hannock Tweya, Christine Kiruthu-Kamamia, Geldert Chiwaya, Caryl Feldacker

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Gillian O'BryanDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.ORCID https://orcid.org/0000-0002-4235-9869
Jacqueline HuwaLighthouse Trust, Lilongwe, Malawi.ORCID https://orcid.org/0000-0001-8786-2487
Odala SandeLighthouse Trust, Lilongwe, Malawi.
Agness ThawaniLighthouse Trust, Lilongwe, Malawi.
Astrid Berner-RodoredaHeidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.ORCID https://orcid.org/0000-0002-5484-890X
Hannock TweyaDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
Christine Kiruthu-KamamiaInternational Training and Education Center for Health (I-TECH), Seattle, Washington, United States of America.
Geldert ChiwayaLighthouse Trust, Lilongwe, Malawi.
Caryl FeldackerDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.

Funding

Malawi HIV Implementation Research Scientist Training Program (MHIRST)D43TW010060 · FIC · UNIV OF NORTH CAROLINA CHAPEL HILL · 2023 to 2025
$900k
The Community-based ART REtention and Suppression (CARES) App: an innovation to improve patient monitoring and evaluation data in community-based antiretroviral therapy programs in Lilongwe, MalawiR21MH127992 · NIMH · UNIVERSITY OF WASHINGTON · PI Caryl Feldacker, Hannock Mukoma Tweya · 2023 to 2023
$199k
FIC NIH HHS D43 TW010060FIC NIH HHS R33 TW011658NIMH NIH HHS R21 MH127992
6 · The paper itself

Abstract

introductionRetention of people living with HIV (PLHIV) on antiretroviral therapy (ART) is critical. Retention is not static: clients cycle in and out of care over the course of treatment. Retention support is also evolving, with interventions like mobile health (mHealth) gaining traction. We aimed to explore ART clients' perspectives and recommend strategies for improved retention support including a two-way-texting (2wT) mHealth intervention in two clinics in Malawi. MATERIALS AND

methodsWe conducted focus group discussions (FGDs) with PLHIV on ART receiving 2wT or standard of care (SoC) retention support to understand client perspectives. FGDs were audio-recorded in Chichewa, translated and transcribed into English. We used the RE-AIM implementation science framework to report findings on the reach, effectiveness, adoption, implementation, and maintenance potential of retention interventions considering individual, clinic/organization, and community factors. Through rapid qualitative analysis, we identified key themes and subthemes.

resultsTen FGDs were conducted with 89 ART clients (aged ≥18 years; 55% female): four FGDs among 2wT participants and six among SoC participants. Few differences were observed between 2wT and SoC clients. All clients appreciated accessing at least one form of support and recommended continuous assistance, regardless of age, sex, or duration on ART. Clients wished to be encouraged by other PLHIV to allay common fears. Groups discussed the need for intensified support to retain young clients or those out of care longer. Individual responsibility was identified as necessary, but insufficient, to improve retention: respondents desired a more positive clinic environment to encourage persistence in care. Fear of stigma, unintended status disclosure, and negative interactions with clinic staff prevent some clients from returning to care.

conclusionPLHIV want differentiated, continuous retention support from other PLHIV coupled with a positive clinic environment to promote retention and reengagement in care. As differentiated retention support is expensive, consideration of cost, feasibility, and sustainability is needed.

Indexed as

Anti-HIV AgentsAnti-Retroviral AgentsHIV InfectionsAdultFemaleFocus GroupsHumansMalawiMaleMiddle AgedQualitative ResearchTelemedicineYoung AdultAnti-HIV AgentsAnti-Retroviral Agents

Identifiers

PMID40424412
PMCPMC12112084

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.