Retention in HIV care depends on patients’ perceptions of the clinic experience

ABSTRACT

Institutional barriers in HIV primary care settings can contribute substantially to disparities in retention in HIV treatment and HIV-related outcomes. This qualitative study compared the perceptions of clinic experiences of persons living with HIV (PLWH) in a Veterans Affairs HIV primary care clinic setting who were retained in care with the experiences of those who were not retained in care. Qualitative data from 25 in-depth interviews were analyzed to identify facilitators and barriers to retention in HIV care. Results showed that participants not retained in care experienced barriers to retention involving dissatisfaction with clinic wait times, low confidence in clinicians, and customer service concerns. For participants retained in care, patience with procedural issues, confidence in clinicians, and interpersonal connections were factors that enhanced retention despite the fact that these participants recognized the same barriers as those who were not retained in care. These findings can inform interventions aimed at improving retention in HIV care.

KEYWORDS:

• HIV
• qualitative analysis
• veterans
• retention
• barriers
• clinic

Acknowledgements

The authors would like to acknowledge the contributions of the following individuals: Hannah Wichmann, Carlos del Rio, MD, James Crowe, Susan Schlueter-Wirtz, MPH, Amanda Williams, Mark Nanes, MD, and Kelcie Landon, MPH.

Disclosure statement

No potential conflict of interest was reported by t he authors.

Additional information

Funding

This study was funded by the Emory Center for AIDS Research [grant number P30 AI050409] and the Infectious Disease Society of America Medical Scholars Program.