title: Perspectives from the Field: HIV Testing and Linkage to Care in North Carolina.
abstract: HIV testing and linkage to care are critical first steps along the care continuum. Targeted efforts are needed in the South to achieve the goals of the National HIV/AIDS Strategy, and qualitative examination of testing and linkage to care from the perspective of professionals in the field can provide nuanced insight into the strengths and limitations of a care system to inform improvement efforts. These issues are explored in North Carolina (NC), with potential applicability to other Southern states.
  
  
  
  Twenty-one interviews were conducted with professionals in the HIV prevention and care systems in NC. Interviews were analyzed for emergent themes.
  
  
  
  Individuals' access barriers, aspects of clinics and clinical care, challenges for community-based organizations, stigma, and the role of the NC Department of Health and Human Services were identified as themes affecting testing and linkage.
  
  
  
  These findings can inform efforts to address HIV testing and linkage to care in NC. This approach may provide beneficial insight for other systems of care.
authors.affiliation: Center for Health Policy and Inequalities Research, Duke University, Duke Global Health Institute, Durham, NC, USA kristen.sullivan@duke.edu.
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Sullivan
authors.affiliation: Center for Health Policy and Inequalities Research, Duke University, Duke Global Health Institute, Durham, NC, USA.
authors.forename: Miriam B
authors.initials: MB
authors.lastname: Berger
authors.affiliation: Center for AIDS Research, University of North Carolina at Chapel Hill, NC, USA.|Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Evelyn Byrd
authors.initials: EB
authors.lastname: Quinlivan
authors.affiliation: Center for Health Policy and Inequalities Research, Duke University, Duke Global Health Institute, Durham, NC, USA.
authors.forename: Heather E
authors.initials: HE
authors.lastname: Parnell
authors.affiliation: Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, NC, USA.|North Carolina Department of Health and Human Services, HIV/STD Prevention Unit, Communicable Disease Branch, Raleigh, NC, USA.
authors.forename: Lynne A
authors.initials: LA
authors.lastname: Sampson
authors.affiliation: North Carolina Department of Health and Human Services, Communicable Disease Branch, Raleigh, NC, USA.
authors.forename: Jacquelyn M
authors.initials: JM
authors.lastname: Clymore
authors.affiliation: Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
authors.forename: Aimee M
authors.initials: AM
authors.lastname: Wilkin
mesh_terms: D003266:Continuity of Patient Care; D015658:HIV Infections / Q000175:diagnosis* / Q000628:therapy*; D006297:Health Services Accessibility; D006801:Humans; D009657:North Carolina; D036301:Qualitative Research; D012424:Rural Population
keywords: HIV/AIDS; health providers; linkage to care; qualitative research; testing