Understanding motivations and resilience-associated factors to promote timely linkage to HIV care: a qualitative study among people living with HIV in western Kenya

ABSTRACT

Understanding motivations and resilience-associated factors that help people newly diagnosed with HIV link to care is critical in the context of universal test and treat. We analyzed 30 in-depth interviews (IDI) among adults aged 18 and older in western Kenya diagnosed with HIV during home-based counseling and testing and who had linked to HIV care. A directed content analysis was performed, categorizing IDI quotations into a table based on linkage stages for organization and then developing and applying codes from self-determination theory and the concept of resilience. Autonomous motivations, including internalized concerns for one’s health and/or to provide care for family, were salient facilitators of accessing care. Controlled forms of motivation, such as fear or external pressure, were less salient. Social support was an important resilience-associated factor fostering linkage. HIV testing and counseling programs which incorporate motivational interviewing that emphasizes motivations related to one’s health or family combined with a social support/navigator approach, may promote timely linkage to care.

KEYWORDS:

• Linkage to HIV care
• self-determination theory
• resilience
• motivational interviewing
• Kenya

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability

Data is available from the Principal Investigator by request.

Additional information

Funding

This work was supported by NIMH [grant number K01MH099966]; NIH/NIAID [grant number T32AI102623] (Stephanie M. DeLong); and Canadian Institutes of Health Research under Grant “Chair of Applied Public Health” (Paula Braitstein).