Abstract
Background
Despite significant progress in HIV services, significant patient loss occurs at every stage of the HIV care continuum. While efforts made by the NDoH aim to combat the HIV epidemic and achieve the 95-95-95 targets, these targets cannot be reached unless PLHIV are effectively linked to and retained in care. This study aims to develop targeted strategies to improve linkage to and retention in HIV care among PLHIV in the Msukaligwa Sub-district, Mpumalanga Province.
Methods
A convergent parallel mixed-methods design will be employed. The study will consist of four phases: (1) a scoping review to identify global strategies for improving HIV care outcomes; (2) a quantitative strand using descriptive cross-sectional and retrospective cohort designs with TIER.Net data (2020–2024) to assess linkage and retention patterns; (3) a qualitative exploratory study using semi-structured interviews with PLHIV and healthcare providers to explore lived experiences, barriers, and facilitators; and (4) development of an evidence-based, context-specific strategy. Quantitative data will be analysed using descriptive and inferential statistics, while qualitative data will undergo thematic analysis guided by the Socio-Ecological Model.
Expected results
The study is expected to identify key individual, interpersonal, and health system factors influencing poor linkage and retention in HIV care. It will also highlight critical gaps along the HIV care continuum and provide insight into patient and provider perspectives.
Conclusion
Findings from this study will inform the development of a tailored, evidence-based strategy to strengthen HIV care engagement in the Msukaligwa Sub-district. This may contribute to improved retention, viral suppression, and progress toward national and global HIV targets.