Lost to Care and Back Again: Patient and Navigator Perspectives on HIV Care Re-engagement
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.
KeywordsHIV/AIDS Retention Re-engagement Patients Health providers Strengths model of case management Navigators
- 2.Bradley H, Hall HI, Wolitski RJ, et al. Vital Signs: HIV diagnosis, care, and treatment among persons living with HIV—United States, 2011. Morb Mortal Wkly Rep. 2014;63(47):1113–7.Google Scholar
- 12.Stricker SM, Fox KA, Baggaley R, et al. Retention in care and adherence to ART are critical elements of HIV care interventions. AIDS Behav. 2013;18(Suppl 5):S465–75.Google Scholar
- 18.Bradford JB, Coleman S, Cunningham W. HIV System Navigation: an emerging model to improve HIV care access. AIDS Patient Care STDS. 2007;21(S1):S-49–58.Google Scholar
- 23.Swygard H, Seña AC, Mobley V, et al. Implementation of statewide team to facilitate linkage and re-engagement in HIV care in North Carolina. N C Med J. (accepted for publication).Google Scholar
- 27.Seña AC, Donovan J, Swygard H, et al. The North Carolina HIV Bridge Counselor Program: outcomes from a statewide level intervention to link and re-engage HIV-infected persons in care in the South. J Acquir Immune Defic Syndr. 2017. https://www.ncbi.nlm.nih.gov/pubmed/28394820. doi:10.1097/QAI.0000000000001389.