Study focus area




The negative impact of patients lost to follow up include: suboptimal adherence, virologic failure, development of resistance, secondary HIV transmission, increased hospitalization costs and reduced survival rate. The Chronic Viral Infection Service (CVIS) at McGill University Health Centre have developed a risk-informed two-step algorithm to identify patients lost to follow-up, who should be targeted for re-engagement into HIV care.

CMI Booklet image two guys hailing cab


In Phase 1, patients are classified as potentially lost to follow-up by their clinical characteristics: Viral load, CD4 count, presence/absence polypharmacy, and time since their last appointment.

In Phase 2, patients who are lost to follow-up will be contacted by nurses trained in motivational interviewing, booked for an appointment within 2- 8 weeks, as per clinical urgency. Patients who subsequently miss their rescheduled appointment will be contacted the same day and re-scheduled. An estimated 25-30 patients will be identified as potentially lost to follow up each month.

Primary Objectives

  • Assess the practicality and acceptability of the among nurses;
  • Determine the acceptability of Phase II of the intervention among patients;
  • Assess the effectiveness of the intervention (Phases I and II); and
  • Ascertain the sociodemographic, psychosocial, and clinical characteristics of patients lost to follow-up and re-engaged.


  • Two general patterns in implementation outcomes (other than fidelity):
    • High pre-implementation scores, followed by a slight drop in earlier months, followed by a return to high scores in later months
    • Lower pre-implementation scores increasing to a plateau
  • Fidelity stable or increasing over study
    • Low rates of “phone calls made” reflective of task shifting
      • Nurses assigned one person as primary for Lost & found activities, who made phone calls each month
      • Possibly an adjustment to human resource limitations – an important risk factor in Lost & Found implementation
  • Early months critical to identify and address threats to Lost & Found implementation
    • Low scores in earlier months reflective of:
      • Technical difficulties, followed by corrections and related adaptations (e.g. improving function of the OOC-RPT)
      • Nature of the intervention, requiring clean-up of the OOC-list in earlier months
    • Similar trends between fidelity to OOC-list, as well as feasibility and acceptability of phone calls
      • Feasibility the most upstream – may be an important factor for Lost & Found implementation.


Dr. Joseph Cox

Dr. Nadine Kronfli


McGill University Health Centre.




Dec 2017-March 2020


Retention in Care and Adherence

Key study materials

ViiV study lead and contact

Duncan Short

Director of Global Implementation Science




This study investigates barriers and facilitators specifically among foreign and US born Spanish and English-speaking Latino MSM.


As part of an effort to re-engage patients into care, this study determined the effectiveness of using an outreach nurse as a direct clinical liaison through the State Bridge Counsellor (SBC) Program


As part of this project, financial incentives were used to engage and retain people living with HIV with the goal of contributing to viral suppression in the Baton Rouge, LA area.

Our partnerships

Our partnerships

We are proud to partner with multiple organizations that work to prevent HIV and improve the lives of people who live with HIV.

Find out more

NP-GBL-HVU-WCNT- 210049 | March 2022

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the package leaflet. You can also report side effects directly via the Yellow Card Scheme at or search for MHRA Yellowcard in the Google Play or Apple App store. By reporting side effects, you can help provide more information on the safety of this medicine.

If you are from outside the UK, you can report adverse events to GSK/ViiV by selecting your region and market, here.