title: "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.
authors: a Department of Psychiatry & Behavioral Medicine, Center for AIDS Intervention Research , Medical College of Wisconsin , Milwaukee , WI , USA.
authors: Michelle R
authors: MR
authors: Broaddus
authors: b Wisconsin Department of Health Services, AIDS/HIV Program , Madison, WI , USA.
authors: Christina R
authors: CR
authors: Hanna
authors: b Wisconsin Department of Health Services, AIDS/HIV Program , Madison, WI , USA.
authors: Casey
authors: C
authors: Schumann
authors: b Wisconsin Department of Health Services, AIDS/HIV Program , Madison, WI , USA.
authors: Alison
authors: A
authors: Meier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D019090:Case Management; D005260:Female; D015658:HIV Infections / Q000451:nursing / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D057545:Social Stigma; D012944:Social Support; D014922:Wisconsin; D055815:Young Adult
keywords: ART adherence; HIV medical care; patient navigation