Objective: To propose practical, standardized definitions for reporting retention for pre-ART care.
Method: Definitions footed on three stages: Stage 1, testing HIV-positive to initial ART eligibility assessment; Stage 2, initial assessment to ART eligibility; and Stage 3, ART eligibility to ART initiation. For each stage, negative outcomes include death, loss, or not being retained.
Results: Stage 1 Retention: proportion of patients who complete initial ART eligibility assessment within 3 months of HIV testing, with reporting of cohort outcomes at 3 and 12 months after HIV testing. Patients who end Stage 1 eligible for ART move directly to Stage 3. Stage 2 Retention: proportion of patients who either: complete all possible ART eligibility re-assessments within 6 months of the site’s standard visit schedule; or had an assessment within 1 year of the time reported to and were not ART eligible at the last assessment. Retention should be reported at 12-month intervals. Stage 3 Retention: initiating ART (i.e. ARVs dispensed) within 3 months of determining ART eligibility, with reporting at 3 months after eligibility and 3 monthly intervals thereafter.
Conclusion: If pre-ART retention is to improve, consistent terminology is needed for collecting data, measuring and reporting outcomes, and comparing results across programs and countries. The definitions we propose offer a strategy for improving the consistency and comparability of future reports.
Keywords: HIV; VIH; abandono; antiretroviral therapy; attrition; cadres à ressources limitées; cuidados previos a la terapia antiretroviral; emplazamientos con pocos recursos; pre‐antiretroviral therapy care; resource‐limited settings; retención; retention; rétention; soins avant la thérapie antirétrovirale; terapia antirretroviral; thérapie antirétrovirale.