Effect of a person-centered care intervention on return and sustained reengagement after treatment interruptions from HIV care in Zambia: A post-hoc analysis of a stepped-wedged cluster randomized trial

A landmark post-hoc analysis of a stepped-wedge cluster randomized trial conducted across twenty-four public health facilities in Zambia has highlighted the profound impact of empathetic healthcare delivery on HIV treatment retention. Researchers investigated whether a multi-component person-centered care (PCC) intervention—designed to improve the interpersonal behavior of healthcare workers—could successfully bridge the gap for patients experiencing treatment interruptions. The findings underscore that cultivating a welcoming clinic environment is paramount in dismantling the psychological barriers that prevent individuals from returning to life-saving antiretroviral therapy. Historically, poor client-provider interactions have reinforced a vicious cycle of missed appointments, treatment interruptions, and eventual fear of returning to health facilities due to anticipated reprimand or stigma. To counter this, the PCC intervention combined targeted training and coaching for healthcare personnel, systematic client experience tracking with direct facility feedback, and modest facility-level incentives. By focusing on the emotional and psychological dimensions of care rather than solely structural logistics, the strategy sought to rebuild trust between vulnerable clients and the health system. Analyzing electronic health records for over 128,000 clients who experienced treatment interruptions across the participating clinics, the study uncovered compelling quantitative benefits. The proportion of individuals returning to care one year post-interruption reached 72.3% under the PCC intervention arm, compared to 67.7% in the control group. Furthermore, among those who successfully reengaged, the intervention arm witnessed a substantial drop in repeat treatment interruptions—falling from 55.6% down to 44.3%—alongside a higher proportion of clients remaining actively retained in care. Public health experts note that these insights arrive at a critical juncture for Zambia