title: The provider role in client engagement in HIV care.
abstract: This multisite, qualitative study examined the process by which persons living with HIV/AIDS (PLWHA) engage in primary HIV medical care for treatment. Using a grounded theory approach, the analysis of narrative data from semi-structured in-depth interviews with PLWHA (n = 76) led to the development of a model describing a cyclic process of engaging in--and falling out of--care. Perceptions of the client-provider relationship emerged as a central element of the process by which persons with HIV engaged--or remained--in care. Provider behaviors that were characterized as engaging, validating, and partnering facilitated engagement and retention in care; behaviors described as paternalistic served as barriers to care. Participants indicated that they desired a care partnership with an empathetic provider who had effective communication skills. These findings provide recommendations for health providers to engage and retain hard-to-reach PLWHA in timely and appropriate HIV care and services.
authors.affiliation: School of Nursing & Health Studies, Georgetown University, Washington, DC 20057, USA. km293@georgetown.edu
authors.forename: R Kevin
authors.initials: RK
authors.lastname: Mallinson
authors.forename: Serena
authors.initials: S
authors.lastname: Rajabiun
authors.forename: Sharon
authors.initials: S
authors.lastname: Coleman
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000628:therapy*; D019538:Health Care Surveys; D006282:Health Personnel; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010817:Physician-Patient Relations