title: 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.
authors.affiliation: a Hubert Department of Global Health , Emory University Rollins School of Public Health , Atlanta , USA.
authors.forename: Matthew H
authors.initials: MH
authors.lastname: Wessinger
authors.affiliation: a Hubert Department of Global Health , Emory University Rollins School of Public Health , Atlanta , USA.
authors.forename: Monique M
authors.initials: MM
authors.lastname: Hennink
authors.affiliation: b Global Health Institute , Duke University , Durham , USA.
authors.forename: Bonnie N
authors.initials: BN
authors.lastname: Kaiser
authors.affiliation: c Department of Medicine , Walter Reed National Military Medical Center , Bethesda , USA.|d Department of Psychiatry , Walter Reed National Military Medical Center , Bethesda , USA.
authors.forename: Jed P
authors.initials: JP
authors.lastname: Mangal
authors.affiliation: e Hospital Medicine Section , Atlanta VA Medical Center , Atlanta , USA.
authors.forename: Runa H
authors.initials: RH
authors.lastname: Gokhale
authors.affiliation: g Atlanta VA Medical Center , Infectious Disease Clinic , Atlanta , USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Ruchin
authors.affiliation: f Department of Infectious Diseases , Emory University School of Medicine , Atlanta , USA.|g Atlanta VA Medical Center , Infectious Disease Clinic , Atlanta , USA.
authors.forename: Abeer
authors.initials: A
authors.lastname: Moanna
authors.affiliation: f Department of Infectious Diseases , Emory University School of Medicine , Atlanta , USA.|g Atlanta VA Medical Center , Infectious Disease Clinic , Atlanta , USA.
authors.forename: David
authors.initials: D
authors.lastname: Rimland
authors.affiliation: h Department of Psychiatry and Behavioral Science , Emory University School of Medicine , Atlanta , USA.
authors.forename: Eugene W
authors.initials: EW
authors.lastname: Farber
authors.affiliation: a Hubert Department of Global Health , Emory University Rollins School of Public Health , Atlanta , USA.|f Department of Infectious Diseases , Emory University School of Medicine , Atlanta , USA.|g Atlanta VA Medical Center , Infectious Disease Clinic , Atlanta , USA.
authors.forename: Vincent C
authors.initials: VC
authors.lastname: Marconi
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003266:Continuity of Patient Care; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010465:Perception; D036301:Qualitative Research; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; barriers; clinic; qualitative analysis; retention; veterans