Applying precision public health concepts to HIV services: using routine health data to explore patterns of patient engagement with antiretroviral care

Patient engagement with HIV care is critical in realising the benefits of antiretroviral therapy, both to individuals and to the health system as a whole. However, engagement is a complex behaviour influenced by many factors outside of the health system’s control, challenging HIV programmes to find novel ways of supporting people to remain engaged with their treatment throughout their lifetime. The concepts of precision public health may be useful in managing people on lifelong antiretroviral treatment, by targeting differentiated models of care to subgroups of people who engage with the system in similar ways. The first step is to identify these groups, profile them, and explore the patterns of engagement behaviour.