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- Title
"It's Me as a Person, Not Me the Disease": Patient Perceptions of an HIV Care Model Designed to Engage Persons with Complex Needs.
- Authors
Beima-Sofie, Kristin; Begnel, Emily R.; Golden, Matthew R.; Moore, Allison; Ramchandani, Meena; Dombrowski, Julia C.
- Abstract
Ending the HIV epidemic will require dedicated efforts to engage the highest need persons living with HIV (PLWH) in treatment. We assessed patient perceptions of a clinic in Seattle, Washington, that is designed for PLWH who do not engage in conventional HIV care. The Max Clinic provides walk-in access to care, incentives for blood draws and achieving viral suppression, and intensive case management. We conducted semistructured individual interviews with 25 patients purposively recruited to obtain diverse viewpoints. Interviews were audio-recorded and transcribed. Analysis used a constant comparative approach to identify major themes related to the components of the program. For many participants, engagement in the Max Clinic was the first time they had success with HIV treatment. Relationships with clinic staff and the ability to receive care on a walk-in basis had the strongest influences on engagement. Participants felt that Max Clinic staff attended to their social circumstances in ways that were distinct from prior care experiences. Walk-in visits removed perceived stigma associated with failure to keep appointments and provided immediate attention to acute concerns. Financial incentives initially motivated participants to attend clinic and take medications, but were less important for supporting ongoing engagement in care. Food incentives motivated patients to seek care and helped them focus on health issues. In summary, patients identified walk-in access to care, monetary and food incentives, and relationships with clinic staff, particularly case managers, as the key elements of an HIV clinic model for high-need PLWH.
- Subjects
ATTENTION; COMPARATIVE studies; CRITICAL care medicine; HEALTH services accessibility; HELP-seeking behavior; HIV infections; PSYCHOLOGY of HIV-positive persons; INTERVIEWING; RESEARCH methodology; MEDICAL appointments; MEDICAL needs assessment; SOCIAL skills; SOCIAL stigma; PATIENT participation; SOCIAL support
- Publication
AIDS Patient Care & STDs, 2020, Vol 34, Issue 6, p267
- ISSN
1087-2914
- Publication type
Article
- DOI
10.1089/apc.2019.0310