Retention in HIV care depends on patients' perceptions of the clinic experience

• Type of Material: Article
• Authors: Matthew H. Wessinger, Emory University; Monique Hennink, Emory University; Bonnie N. Kaiser, Duke University; Jed P. Mangal, Walter Reed National Military Medical Center; Runa H. Gokhale, Atlanta Veterans Affairs Medical Center; Lauren Ruchin, Atlanta Veterans Affairs Medical Center; Abeer Moanna, Emory University; David Rimland, Emory University; Eugene Farber, Emory University; Vincent Marconi, Emory University
• Language: English
• Date: 2017-01-01
• Publisher: Routledge Journals, Taylor & Francis Ltd.
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 Informa UK Limited.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1080/09540121.2017.1308465
• Title of Journal or Parent Work: AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV
• Volume: 29
• Issue: 10
• Start Page: 1212
• End Page: 1217
• Grant/Funding Information: This study was funded by the Emory Center for AIDS Research (Grant P30 AI050409) and the Infectious Disease Society of America Medical Scholars Program.
• Keywords: Life Sciences & Biomedicine; qualitative analysis; Social Sciences; clinic; veterans; Health Policy & Services; barriers; Continuum; Psychology, Multidisciplinary; Respiratory System; Biomedical Social Sciences; Science & Technology; retention; Psychology; Health Care Sciences & Services; Public, Environmental & Occupational Health; Health care; HIV; Social Sciences, Biomedical
• Research Categories: Health Sciences, Health Care Management; Engineering, Biomedical; Health Sciences, Public Health; Psychology, Cognitive

Abstract

Institutional barriers in HIV primary care settings can contribute substantially to disparities in retention in HIV treatment and HIV-related outcomes. This qualitative study compared the perceptions of clinic experiences of persons living with HIV (PLWH) in a Veterans Affairs HIV primary care clinic setting who were retained in care with the experiences of those who were not retained in care. Qualitative data from 25 in-depth interviews were analyzed to identify facilitators and barriers to retention in HIV care. Results showed that participants not retained in care experienced barriers to retention involving dissatisfaction with clinic wait times, low confidence in clinicians, and customer service concerns. For participants retained in care, patience with procedural issues, confidence in clinicians, and interpersonal connections were factors that enhanced retention despite the fact that these participants recognized the same barriers as those who were not retained in care. These findings can inform interventions aimed at improving retention in HIV care.