“She makes me feel that I'm not alone”: Linkage to Care Specialists provide social support to people living with HIV

Abstract

Wisconsin's Linkage to Care intervention incorporates elements of individually tailored patient navigation and case management designed to increase linkage and retention in HIV-related medical care. It is delivered by Linkage to Care Specialists in HIV medical clinics and community-based agencies. Researchers interviewed a diverse sample of clients to conduct preliminary evaluation of the pilot phase of this intervention. The participants' relationships with their Specialists emerged as a major unifying theme of the data. Comfortable and close relationships with Specialists served as motivation to adhere to medical care, mitigated negative feelings associated with HIV-related stigma, and resulted in increased comfort with medical care and positive health outcomes including engagement in care and undetectable viral load. As a result of the Specialists' support, many participants were reluctant to transition out of the Linkage to Care program. The positive effects demonstrated by Specialists are balanced against the costs of small caseloads that are potentially not feasible within traditional case management models. Future interventions to increase medical care engagement, among HIV+ individuals at risk of lack of engagement, should develop strategies to “personalize” the patient experiences within health care and psychosocial services delivery systems, as well as screening tools to triage clients into different levels of personal service provision intensity based on need and desire.

Keywords:

• HIV medical care
• ART adherence
• patient navigation

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Systems Linkages and Access to Care for Populations at High Risk of HIV Infection Initiative Special Project of National Significance, HIV/AIDS Programs, Health Resources and Services Administration [grant number H97HA22698]. Preparation of this publication was supported by the National Institute of Mental Health [grant number P30MH052776].