A Mixed-Methods Exploration of the Needs of People Living with HIV (PLWH) Enrolled in Access to Care, a National HIV Linkage, Retention and Re-Engagement in Medical Care Program

Maulsby, Cathy; Enobun, Blessing; Batey, D. Scott; Jain, Kriti; Riordan, Maura; Werner, Melissa; Holtgrave, David R.

doi:10.1007/s10461-017-1809-3

Cited by 19 publications

(9 citation statements)

References 19 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results are consistent with numerous other studies which have found that unmet transportation needs have a negative impact on retention in care and clinical outcomes. 24,34,35 The evidence from our study supports broadening and strengthening transportation assistance programs.…”

Section: Discussionsupporting

confidence: 66%

The Association of Unmet Needs With Subsequent Retention in Care and HIV Suppression Among Hospitalized Patients With HIV Who Are Out of Care

Dandachi

May

Davila

et al. 2019

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Background: Unmet needs among hospitalized patients with HIV may prevent engagement in HIV care leading to worse clinical outcomes. Our aim was to examine the role of unmet subsistence needs (e.g. housing, transportation, food) and medical needs (e.g. mental health, substance abuse treatment) as barriers for retention in HIV care and viral load suppression. Methods: We utilized data from the Mentor Approach for Promoting Patients’ Self-Care intervention study, the enrolled hospitalized HIV-patients at a large publicly funded hospital between 2010 and 2013, who were out-of-care. We examined the effect of unmet needs on retention in HIV care (attended HIV appointments within 0–30 days and 30–180 days) and viral load suppression, six months after discharge. Results: 417 participants were enrolled, 78% reported having ≥1 unmet need at baseline, most commonly dental care (55%), financial (43%), or housing needs (34%). Participants with unmet needs at baseline, compared to those with no needs, were more likely to be African American, have an existing HIV diagnosis and insured. An unmet need for transportation was associated with lower odds of retention in care (OR: 0.5; 95% CI:0.34–0.94, p=0.03), even after adjusting for other factors. Compared to participants with no need, those who reported ≥3 unmet subsistence needs were less likely to demonstrate viral load improvement (OR: 0.51; 95% CI:0.28–0.92; p=0.03) and to be retained in care (OR: 0.52; 95% CI:0.28–0.95; p=0.03). Conclusion: Broader access to programs that can assist in meeting subsistence needs among hospitalized patients could have significant individual and public health benefits.

show abstract

Section: Discussionsupporting

confidence: 66%

The Association of Unmet Needs With Subsequent Retention in Care and HIV Suppression Among Hospitalized Patients With HIV Who Are Out of Care

Dandachi

May

Davila

et al. 2019

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

show abstract

“…In the Southern US, medical mistrust [ 4 ] and pervasive stigmas (e.g., around HIV [ 5 ], minority sexual orientation, poverty, substance abuse, and mental disorders [ 6 ]) pose additional retention challenges [ 7 ]. Evidence-based retention interventions address many of these barriers and include: provision of social support services, case management [ 8 ], child care, housing services, appointment reminders, co-location of services, appointment accompaniment [ 9 ], patient navigators [ 10 ], peer support [ 11 ], educational brochures [ 12 ], outreach, and transportation assistance [ 8 , 9 , 13 – 16 ]. While each of these interventions has demonstrated promise, continued shortcomings in achieving national retention goals suggest the need for new re-engagement and retention strategies tailored to the needs of PLWH who have fallen out of care [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to use of a mobile HIV care model to re-engage and retain out-of-care people living with HIV in Atlanta, Georgia

et al. 2021

View full text Add to dashboard Cite

Novel strategies to re-engage and retain people living with HIV (PLWH) who are out of care are greatly needed. While mobile clinics have been used effectively for HIV testing and linkage, evidence guiding their use in providing HIV care domestically has been limited. To guide the development of a mobile HIV clinic (MHC) model as a strategy to re-engage and retain PLWH who are out of care, we aimed to explore stakeholder perceptions of barriers and facilitators to MHC implementation and use. From June 2019-July 2020, we conducted 41 in-depth interviews with HIV clinic providers, administrators, staff, legal authorities, and community advisory board members, PLWH, AIDS service organizations and city officials in Atlanta, Georgia, and domestic and international mobile health clinics to explore barriers and facilitators to use of MHCs. Interviews were transcribed, coded and thematically analysed. Barriers raised include potential for: breach of confidentiality with resulting heightened stigmatization, fractured continuity of care, safety concerns, staffing challenges, and low community acceptance of MHC presence in their locality. Participants provided suggestions regarding appropriate exterior design, location, timing, and co-delivery of non-HIV services that could facilitate MHC acceptance and address the concerns. In identifying key barriers and facilitators to MHC use, this study informs design and implementation of an MHC as a novel strategy for re-engaging and retaining PLWH who are out of care.

show abstract

“…No measure of substance use was associated with retention in care which is not consistent with other studies. 39 This may be due to the lack of validated measures of substance use that are used by the Ryan White Program system given their primary goal of identifying client service needs.…”

Section: Discussionmentioning

confidence: 99%

Differential Role of Psychosocial, Health Care System and Neighborhood Factors on the Retention in HIV Care of Women and Men in the Ryan White Program

Trepka

Sheehan

Dawit

et al. 2020

J Int Assoc Provid AIDS Care

View full text Add to dashboard Cite

We investigated potential differential impact of barriers to HIV care retention among women relative to men. Client intake, health assessment, service, and laboratory information among clients receiving medical case management during 2017 in the Miami-Dade County Ryan White Program (RWP) were obtained and linked to American Community Survey data by ZIP code. Cross-classified multilevel logistic regression analysis was conducted. Among 1609 women and 5330 men, 84.6% and 83.7% were retained in care. While simultaneously controlling for all demographic characteristics, vulnerable/enabling factors, and neighborhood indices in the model, younger age, being US born, not working, and having a medical provider with low volume (<10) of clients remained associated with non-retention in care among women and men; while having ≥3 minors in the household and being perinatally infected were additionally associated with retention only for women. Both gender-specific and gender-non-specific barriers should be considered in efforts to achieve higher retention rates.

show abstract

A Mixed-Methods Exploration of the Needs of People Living with HIV (PLWH) Enrolled in Access to Care, a National HIV Linkage, Retention and Re-Engagement in Medical Care Program

Cited by 19 publications

References 19 publications

The Association of Unmet Needs With Subsequent Retention in Care and HIV Suppression Among Hospitalized Patients With HIV Who Are Out of Care

The Association of Unmet Needs With Subsequent Retention in Care and HIV Suppression Among Hospitalized Patients With HIV Who Are Out of Care

Barriers and facilitators to use of a mobile HIV care model to re-engage and retain out-of-care people living with HIV in Atlanta, Georgia

Differential Role of Psychosocial, Health Care System and Neighborhood Factors on the Retention in HIV Care of Women and Men in the Ryan White Program

Contact Info

Product

Resources

About