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Factors That Influence Linkages to HIV Continuum of Care Services: Implications for Multi-Level Interventions

Worldwide, the human immunodeficiency virus (HIV) continuum of care involves health promotion providers (e.g., social workers and health educators) linking patients to medical personnel who provide HIV testing, primary care, and antiretroviral treatments. Regrettably, these life-saving linkages are...

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Autores principales: Pinto, Rogério M., Witte, Susan S., Filippone, Prema L., Baird, Karen L., Whitman, Wendy R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707994/
https://www.ncbi.nlm.nih.gov/pubmed/29112126
http://dx.doi.org/10.3390/ijerph14111355
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author Pinto, Rogério M.
Witte, Susan S.
Filippone, Prema L.
Baird, Karen L.
Whitman, Wendy R.
author_facet Pinto, Rogério M.
Witte, Susan S.
Filippone, Prema L.
Baird, Karen L.
Whitman, Wendy R.
author_sort Pinto, Rogério M.
collection PubMed
description Worldwide, the human immunodeficiency virus (HIV) continuum of care involves health promotion providers (e.g., social workers and health educators) linking patients to medical personnel who provide HIV testing, primary care, and antiretroviral treatments. Regrettably, these life-saving linkages are not always made consistently and many patients are not retained in care. To design, test and implement effective interventions, we need to first identify key factors that may improve linkage-making. To help close this gap, we used in-depth interviews with 20 providers selected from a sample of 250 participants in a mixed-method longitudinal study conducted in New York City (2012–2017) in order to examine the implementation of HIV services for at-risk populations. Following a sociomedical framework, we identified provider-, interpersonal- and environmental-level factors that influence how providers engage patients in the care continuum by linking them to HIV testing, HIV care, and other support services. These factors occurred in four domains of reference: Providers’ Professional Knowledge Base; Providers’ Interprofessional Collaboration; Providers’ Work-Related Changes; and Best Practices in a Competitive Environment. Of particular importance, our findings show that a competitive environment and a fear of losing patients to other agencies may inhibit providers from engaging in linkage-making. Our results suggest relationships between factors within and across all four domains; we recommend interventions to modify factors in all domains for maximum effect toward improving care continuum linkage-making. Our findings may be applicable in different areas of the globe with high HIV prevalence.
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spelling pubmed-57079942017-12-05 Factors That Influence Linkages to HIV Continuum of Care Services: Implications for Multi-Level Interventions Pinto, Rogério M. Witte, Susan S. Filippone, Prema L. Baird, Karen L. Whitman, Wendy R. Int J Environ Res Public Health Article Worldwide, the human immunodeficiency virus (HIV) continuum of care involves health promotion providers (e.g., social workers and health educators) linking patients to medical personnel who provide HIV testing, primary care, and antiretroviral treatments. Regrettably, these life-saving linkages are not always made consistently and many patients are not retained in care. To design, test and implement effective interventions, we need to first identify key factors that may improve linkage-making. To help close this gap, we used in-depth interviews with 20 providers selected from a sample of 250 participants in a mixed-method longitudinal study conducted in New York City (2012–2017) in order to examine the implementation of HIV services for at-risk populations. Following a sociomedical framework, we identified provider-, interpersonal- and environmental-level factors that influence how providers engage patients in the care continuum by linking them to HIV testing, HIV care, and other support services. These factors occurred in four domains of reference: Providers’ Professional Knowledge Base; Providers’ Interprofessional Collaboration; Providers’ Work-Related Changes; and Best Practices in a Competitive Environment. Of particular importance, our findings show that a competitive environment and a fear of losing patients to other agencies may inhibit providers from engaging in linkage-making. Our results suggest relationships between factors within and across all four domains; we recommend interventions to modify factors in all domains for maximum effect toward improving care continuum linkage-making. Our findings may be applicable in different areas of the globe with high HIV prevalence. MDPI 2017-11-07 2017-11 /pmc/articles/PMC5707994/ /pubmed/29112126 http://dx.doi.org/10.3390/ijerph14111355 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pinto, Rogério M.
Witte, Susan S.
Filippone, Prema L.
Baird, Karen L.
Whitman, Wendy R.
Factors That Influence Linkages to HIV Continuum of Care Services: Implications for Multi-Level Interventions
title Factors That Influence Linkages to HIV Continuum of Care Services: Implications for Multi-Level Interventions
title_full Factors That Influence Linkages to HIV Continuum of Care Services: Implications for Multi-Level Interventions
title_fullStr Factors That Influence Linkages to HIV Continuum of Care Services: Implications for Multi-Level Interventions
title_full_unstemmed Factors That Influence Linkages to HIV Continuum of Care Services: Implications for Multi-Level Interventions
title_short Factors That Influence Linkages to HIV Continuum of Care Services: Implications for Multi-Level Interventions
title_sort factors that influence linkages to hiv continuum of care services: implications for multi-level interventions
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707994/
https://www.ncbi.nlm.nih.gov/pubmed/29112126
http://dx.doi.org/10.3390/ijerph14111355
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