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Purpose of Review <p>Death following hospitalization remains strikingly high for people living with HIV (PLHIV) in sub-Saharan Africa. Hospitalization represents a key opportunity for targeted interventions, yet evidence for effective approaches remains limited. We conducted a best-evidence narrative review, framed by the Andersen Model of Health Care Utilization, to examine factors contributing to post-hospital mortality and assess recent interventions.</p> Recent Findings <p>PLHIV in sub-Saharan Africa have a 12–26% risk of death within 3–6 months of discharge. Social and structural barriers—including poverty, stigma, food insecurity, and low self-efficacy—are central mediating factors. We reviewed three disease-neutral interventions (HomeLink, Daraja, ReCharge) providing home-based support, counseling, and care linkage. While feasible and acceptable, mortality impact was mixed due to small sample sizes and advanced illness.</p> Summary <p>The hospital-to-home transition is a critical window for intensified differentiated services to reduce mortality among PLHIV. Further research is needed to define scalable and cost-effective models to improve survival and close gaps in HIV care.</p>

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Social and Structural Interventions to Reduce Strikingly High Post-Hospital Mortality for People Living with HIV in Sub-Saharan Africa

  • 期刊论文

  • 发表日期：

    2025年8月7日

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  • Cassidy W. Claassen,
  • Tonderai Mabuto,
  • Kate Shearer,
  • Jane Park,
  • Megan Willkens,
  • Chiti Bwalya,
  • Benson Issarow,
  • Cecilia Kanyama,
  • Rob N. Peck,
  • Michael Vinikoor,
  • Christopher J. Hoffmann

摘要

Purpose of Review

Death following hospitalization remains strikingly high for people living with HIV (PLHIV) in sub-Saharan Africa. Hospitalization represents a key opportunity for targeted interventions, yet evidence for effective approaches remains limited. We conducted a best-evidence narrative review, framed by the Andersen Model of Health Care Utilization, to examine factors contributing to post-hospital mortality and assess recent interventions.

Recent Findings

PLHIV in sub-Saharan Africa have a 12–26% risk of death within 3–6 months of discharge. Social and structural barriers—including poverty, stigma, food insecurity, and low self-efficacy—are central mediating factors. We reviewed three disease-neutral interventions (HomeLink, Daraja, ReCharge) providing home-based support, counseling, and care linkage. While feasible and acceptable, mortality impact was mixed due to small sample sizes and advanced illness.

Summary

The hospital-to-home transition is a critical window for intensified differentiated services to reduce mortality among PLHIV. Further research is needed to define scalable and cost-effective models to improve survival and close gaps in HIV care.