Document Type : Review Article

Authors

• sima Morgan ¹
• Tejas Wakde ²
• Marziyeh Najafi ³
• samin shokravi ⁴
• Roya Rajaee ⁵
• Aliosman Balkan ⁶
• Zoha Aleem ⁷

¹ Sima Marzban. Associate Professor at Department of Health Sciences, Marieb College of Health and Human Services, Florida Gulf Coast University, USA. Email: Simmarzb@gmail.com ORCID ID: 0000-0002-2464-0753

² TDR Grantee at IIHMR University, Jaipur, India. Email: Tejas.mphis02@iihmr.in ORCID: 0009-0003-8077-2819.

³ TDR Grantee at IIHMR University, Jaipur, India. Email: Marziyeh.mphis02@iihmr.in. ORCID: 0000-0002-5445-2235

⁴ Clinical Research Scholar, University of Florida, USA

⁵ 4. Department of Healthcare Management, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran. Email: Rajaeeroya@ymail.com. ORCID: 0000-0002-1449-5775

⁶ Faculty of Medicine, Bezmialem University, Turkey. Email: Balkanaliosman26@gmail.com

⁷ Batterjee Medical College, Saudi Arabia. Email: zaas17@gmail.com

Abstract

Background: Quality improvement (QI) approaches are increasingly used to strengthen HIV services, but their effects across the HIV care continuum remain unclear.
Methods: A systematic review of QI interventions in HIV care was conducted using PubMed, Scopus, and Web of Science up to May 2023. Studies of any design evaluating QI interventions for people living with HIV or at‑risk populations were included. Searches combined HIV and QI terms and were limited by outcome‑related keywords and English‑language publications. Study quality was assessed using the CASP checklist, and results were synthesised across clinical, behavioural, and health‑system domains.
Results: Thirty‑three studies met inclusion criteria, mostly from 2013–2023 and primarily based in the United States and sub‑Saharan Africa. Clinical QI efforts improved HIV testing, early infant diagnosis, and viral load monitoring. Patient‑centred and community‑based approaches strengthened adherence, retention in care, and stigma reduction, particularly among adolescents and key populations. System‑level QI initiatives, such as continuous improvement programmes and national collaboratives, promoted better service integration but required strong leadership and resources. Multi‑component QI models showed more consistent benefits than single‑strategy interventions.
Conclusions: QI interventions can improve multiple HIV care continuum outcomes, but evidence remains variable. The outcome‑restricted, English‑only search strategy may have excluded relevant studies. Broader search methods and stronger evaluation designs are needed to better understand the impact and scalability of HIV QI interventions.

Keywords

• Quality Improvement
• HIV Infections
• Continuity of Patient Care
• Patient-Centered Care
• Evidence-Based Practice

Main Subjects

• Health Services Management