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One size does not fit all: Preferences for HIV care delivery among out-of-care people living with HIV in the Southeastern United States

Approximately half of the people with HIV (PWH) in the United States are retained in HIV care and only 57% have achieved viral suppression, due to barriers including transportation access, stigma, poor mental health, substance use, and medical mistrust. Community-based HIV care models have potential...

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Autores principales: Jones, Marxavian D., Dyer, Kelly, Nedell, Emma R., Fletcher, Michelle R., Grimsley Ackerley, Cassie, Hussen, Sophia A., Kalokhe, Ameeta S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9844861/
https://www.ncbi.nlm.nih.gov/pubmed/36649350
http://dx.doi.org/10.1371/journal.pone.0276852
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author Jones, Marxavian D.
Dyer, Kelly
Nedell, Emma R.
Fletcher, Michelle R.
Grimsley Ackerley, Cassie
Hussen, Sophia A.
Kalokhe, Ameeta S.
author_facet Jones, Marxavian D.
Dyer, Kelly
Nedell, Emma R.
Fletcher, Michelle R.
Grimsley Ackerley, Cassie
Hussen, Sophia A.
Kalokhe, Ameeta S.
author_sort Jones, Marxavian D.
collection PubMed
description Approximately half of the people with HIV (PWH) in the United States are retained in HIV care and only 57% have achieved viral suppression, due to barriers including transportation access, stigma, poor mental health, substance use, and medical mistrust. Community-based HIV care models have potential to address the diverse needs of patients and to improve retention in care, but their success is contingent on acceptance by patients and key community stakeholders. Recognizing that the preferences of PWH who are out-of-care (PWH-OOC) likely differ from those retained in care, we conducted a mixed-methods study from June 2019 to May 2021 composed of surveys with PWH-OOC (n = 50) and in-depth interviews with key clinic and community stakeholders (n = 41) to examine the relative preference and perceived advantages and disadvantages for six different community-based HIV care models versus the traditional fixed-clinic model. Survey data was analyzed to assess average rank preference for each care model and interview transcripts were thematically coded to examine factors influencing model acceptance. The highest preference for care delivery was via a mobile clinic, followed by community-based peer navigation, primary care clinics, telemedicine, traditional HIV subspeciality clinic, homeless shelter, and drug treatment center. Common factors influencing preference included convenience, accessibility, potential to preserve confidentiality, quality of care assurance, opportunity to develop rapport with their HIV care provider, access to a smart device, and potential to alleviate versus exacerbate HIV stigma. Participants discussed need for integration of care models and for individuals to choose different care models at different times. Providers and patients differed in preference for care model and weighting of relative advantages and disadvantages of each. Findings highlight the need to integrate alternative, community-based care models into the national plan to end the HIV epidemic and to allow for PWH-OOC to choose the model most fitting based on individual circumstances.
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spelling pubmed-98448612023-01-18 One size does not fit all: Preferences for HIV care delivery among out-of-care people living with HIV in the Southeastern United States Jones, Marxavian D. Dyer, Kelly Nedell, Emma R. Fletcher, Michelle R. Grimsley Ackerley, Cassie Hussen, Sophia A. Kalokhe, Ameeta S. PLoS One Research Article Approximately half of the people with HIV (PWH) in the United States are retained in HIV care and only 57% have achieved viral suppression, due to barriers including transportation access, stigma, poor mental health, substance use, and medical mistrust. Community-based HIV care models have potential to address the diverse needs of patients and to improve retention in care, but their success is contingent on acceptance by patients and key community stakeholders. Recognizing that the preferences of PWH who are out-of-care (PWH-OOC) likely differ from those retained in care, we conducted a mixed-methods study from June 2019 to May 2021 composed of surveys with PWH-OOC (n = 50) and in-depth interviews with key clinic and community stakeholders (n = 41) to examine the relative preference and perceived advantages and disadvantages for six different community-based HIV care models versus the traditional fixed-clinic model. Survey data was analyzed to assess average rank preference for each care model and interview transcripts were thematically coded to examine factors influencing model acceptance. The highest preference for care delivery was via a mobile clinic, followed by community-based peer navigation, primary care clinics, telemedicine, traditional HIV subspeciality clinic, homeless shelter, and drug treatment center. Common factors influencing preference included convenience, accessibility, potential to preserve confidentiality, quality of care assurance, opportunity to develop rapport with their HIV care provider, access to a smart device, and potential to alleviate versus exacerbate HIV stigma. Participants discussed need for integration of care models and for individuals to choose different care models at different times. Providers and patients differed in preference for care model and weighting of relative advantages and disadvantages of each. Findings highlight the need to integrate alternative, community-based care models into the national plan to end the HIV epidemic and to allow for PWH-OOC to choose the model most fitting based on individual circumstances. Public Library of Science 2023-01-17 /pmc/articles/PMC9844861/ /pubmed/36649350 http://dx.doi.org/10.1371/journal.pone.0276852 Text en © 2023 Jones et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Jones, Marxavian D.
Dyer, Kelly
Nedell, Emma R.
Fletcher, Michelle R.
Grimsley Ackerley, Cassie
Hussen, Sophia A.
Kalokhe, Ameeta S.
One size does not fit all: Preferences for HIV care delivery among out-of-care people living with HIV in the Southeastern United States
title One size does not fit all: Preferences for HIV care delivery among out-of-care people living with HIV in the Southeastern United States
title_full One size does not fit all: Preferences for HIV care delivery among out-of-care people living with HIV in the Southeastern United States
title_fullStr One size does not fit all: Preferences for HIV care delivery among out-of-care people living with HIV in the Southeastern United States
title_full_unstemmed One size does not fit all: Preferences for HIV care delivery among out-of-care people living with HIV in the Southeastern United States
title_short One size does not fit all: Preferences for HIV care delivery among out-of-care people living with HIV in the Southeastern United States
title_sort one size does not fit all: preferences for hiv care delivery among out-of-care people living with hiv in the southeastern united states
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9844861/
https://www.ncbi.nlm.nih.gov/pubmed/36649350
http://dx.doi.org/10.1371/journal.pone.0276852
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