Bibliographic information
GuidelineConsolidated HIV guidelines: service delivery
Year of Publication2026
Issuing InstitutionWorld Health Organization
Recommendation
New
HIV programmes should implement interventions to trace people who have disengaged from care and provide support for re-engagement
Recommended in favor
Strong
Certainty of evidence
Low
Notes and Remarks
- A non-judgemental approach is essential to supporting people to return to care.
- Health-care providers should assess, during routine clinical encounters, factors associated with increased risk of disengagement from HIV care.
- The criteria for tracing and recall should consider those who are seven or more calendar days late for a scheduled appointment.
- Priority for tracing should focus on those who recently started treatment, who have abnormal test results, who have a history of advanced HIV disease and who are not yet receiving treatment. Other priority groups include pregnant and breastfeeding women, children and adolescents.
- Clients should be provided with the opportunity to consent to tracing when ART follow-up is discussed during counselling and at ART initiation.
- Tracing is usually carried out by health facility staff, sometimes with social or community health workers, and requires training and resources, including establishing systems to trace and support re-engagement.
- Tracing may be carried out through text messages, phone calls or visits in the community.
- The frequency of tracing interventions and when tracing will stop should be clearly defined.
- Programme- or facility-level confidential client contact details should be kept up to date to ensure successful tracing if required.
- Direct re-entry into differentiated service delivery models for clients established on treatment should be considered to facilitate retention and adherence for those who return to care within three months of their scheduled appointment.
- Understanding client-reported reasons for disengagement is essential for identifying both general and local causes of retention failures.
- Adequately assessing the risks of tracing activities for vulnerable and key populations is critical.