{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T09:16:49Z","timestamp":1777972609833,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100015652","name":"Barts Charity","doi-asserted-by":"publisher","award":["MGU0574"],"award-info":[{"award-number":["MGU0574"]}],"id":[{"id":"10.13039\/100015652","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>SHIELD is a London\u2010based study of engagement in HIV clinical care during and after the COVID\u201019 pandemic. We document the characteristics of service users who either re\u2010engaged or disengaged with HIV care, together with reflections of HIV clinical service\u2010providers to inform recommendations that address care retention for the long term.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using an exploratory mixed methods approach, service\u2010users aged \u226518\u2009years who re\u2010engaged (1 March 2020\u201331 August 2020) or disengaged from clinical care (no contact with service 1 March 2020\u201328 February 2021) at 8 London HIV services were identified by retrospective records review. Demographics and clinical data were summarized descriptively. For people who re\u2010engaged, follow\u2010up data were collected at 24\u2009months and in those who disengaged, at a single timepoint (1 March 2023). Semi\u2010structured interviews with clinic staff were analysed thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 122 people disengaged and 89 re\u2010engaged. In those who re\u2010engaged, a 24\u2010month follow\u2010up showed 71.3% on antiretrovirals, 63.6% virally suppressed and 67.9% had a future clinician appointment booked. For people who disengaged, by 1 March 2023, 21% were on antiretrovirals and 27% had a future appointment booked. Interviews with 11 service providers explored COVID\u201019's impact on clinical services, multilevel interactions that influenced engagement, and approaches to re\u2010engaging people.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found that COVID\u201019 exposed existing vulnerabilities deterring access to HIV clinical care, as well as being itself an additional factor. For some people, the pandemic provided an opportunity to re\u2010engage. We recommend that retention in care is prioritized in policy and financially, that clinical services provide holistic person\u2010centred care, and improve ways to identify those who leave care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70181","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T11:01:15Z","timestamp":1767178875000},"page":"678-689","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Supporting long\u2010term engagement in\n                    <scp>HIV<\/scp>\n                    clinical care: Learning from the\n                    <scp>COVID<\/scp>\n                    \u201019 pandemic"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3230-758X","authenticated-orcid":false,"given":"R.","family":"Dhairyawan","sequence":"first","affiliation":[{"name":"SHARE Collaborative, Blizard Institute Queen Mary University of London  London UK"},{"name":"Barts Health NHS Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1909-2481","authenticated-orcid":false,"given":"Sara","family":"Paparini","sequence":"additional","affiliation":[{"name":"SHARE Collaborative, Wolfson Institute of Population Health Queen Mary University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Smuk","sequence":"additional","affiliation":[{"name":"SHARE Collaborative, Blizard Institute Queen Mary University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Sidat","sequence":"additional","affiliation":[{"name":"SHARE Collaborative, Wolfson Institute of Population Health Queen Mary University of London  London UK"},{"name":"Positively UK  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Mbewe","sequence":"additional","affiliation":[{"name":"SHARE Collaborative, Wolfson Institute of Population Health Queen Mary University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Petretti","sequence":"additional","affiliation":[{"name":"Positively UK  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0570-095X","authenticated-orcid":false,"given":"V.","family":"Martin","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division UK Health Security Agency  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8965-4400","authenticated-orcid":false,"given":"S.","family":"Dakshina","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Alexander","sequence":"additional","affiliation":[{"name":"North Middlesex University Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. 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