Retain6: Models of care for the first 6 months of HIV treatment

Please visit the Retain6 project website at

For HIV-positive patients in sub-Saharan Africa and globally, the first six months after initiating lifelong antiretroviral therapy (ART) pose the greatest risk of loss to follow up. Patients who make it through the first six months have a good chance of being retained on ART for the long term, but many drop out before reaching the six-month point. Building on a technical consultation held in March 2020 and an associated journal article, the Retain6 project aims to develop new models of differentiated service delivery for patients in their first six months on ART, in an effort to improve retention in care during this period. Retain6 hypothesizes that 1) a majority of early patients will flourish with a simple, low intensity service delivery model, while a minority will need and/or want a more intense model; 2) both retention in care and resource allocation can be improved based on this premise; and 3) naïve and non-naïve initiators will have different needs that may require different models of care. A 3.25 year project, Retain6 supports a combination of observational and interventional research in South Africa and Zambia, in collaboration with the Health Economics and Epidemiology Research Office (HE2RO) in South Africa and the Clinton Health Access Initiative (CHAI) in Zambia. 
Boston University investigators Sydney Rosen (PI), Nancy Scott, Mariet Benade
Partner organizations HE2RO,  CHAI
Countries South Africa, Zambia
Project period October 2021-December 2024
Funder Bill & Melinda Gates Foundation
Project website
Contacts Sydney Rosen

Publications and Other Documents

Rosen S, Grimsrud A, Katz I, Ehrenkranz P. Models of service delivery for optimizing a patient’s first six months on ART: an applied research agenda. Gates Open Res 2020; 4:116. PMID: 32875281