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Lost to Care and Back Again: Patient and Navigator Perspectives on HIV Care Re-engagement

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Abstract

Engagement in HIV care is critical to achieve viral suppression and ultimately improve health outcomes for people living with HIV (PLWH). However, maintaining their engagement in care is often a challenging goal. Utilizing patient navigators, trained in an adapted ARTAS intervention, to help re-engage out-of-care PLWH has proven to be a valuable resource. This qualitative study describes the encounters between PLWH (n = 11) and their care re-engagement navigators (n = 9). Participants were interviewed in-person; interviews were transcribed and analyzed using the strengths model of case management. PLWH shared how working with navigators increased their motivation to return to HIV care and assisted them to overcome barriers that were a hindrance to care engagement. Navigators described a strengths-based approach to working with their clients, thus helping facilitate PLWH care re-engagement goals and successes. Results from this study may inform the development of effective HIV navigation programs to re-engage out-of-care PLWH, often the hardest-to-engage.

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Acknowledgements

This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number H97HA22695, Systems Linkages for Access to Care Initiative, a total award of $3,969,193, and support did not include nongovernmental sources. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. The authors wish to thank the study participants for contributing their time and insight and Sarah Rutgers and Emily Wise for their manuscript assistance. Thank you as well to collaborating researchers Shannon Fuller, Kimberly Koester, Andres Maiorana and Janet Myers at the University of California at San Francisco, Evaluation and Technical Assistance Center.

Funding

This study was funded by Health Resources and Services Administration (Grant Number H97HA22695).

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Authors and Affiliations

  1. Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, NC, USA

    Heather E. Parnell, Miriam B. Berger & Kristen A. Sullivan

  2. School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Margaret W. Gichane

  3. Division of Public Health, Communicable Disease Branch, North Carolina Department of Health and Human Services, Raleigh, NC, USA

    Jacquelyn M. Clymore

  4. Institute for Global Health and Infectious Diseases, UNC Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Anna F. LeViere & Evelyn Byrd Quinlivan

Authors
  1. Heather E. Parnell
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  2. Miriam B. Berger
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  3. Margaret W. Gichane
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  4. Anna F. LeViere
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  5. Kristen A. Sullivan
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  6. Jacquelyn M. Clymore
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  7. Evelyn Byrd Quinlivan
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Correspondence to Heather E. Parnell.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Parnell, H.E., Berger, M.B., Gichane, M.W. et al. Lost to Care and Back Again: Patient and Navigator Perspectives on HIV Care Re-engagement. AIDS Behav 23 (Suppl 1), 61–69 (2019). https://doi.org/10.1007/s10461-017-1919-y

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  • DOI: https://doi.org/10.1007/s10461-017-1919-y

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