“I Don’t Feel Judged, I Don’t Feel Less of a Person” - Engaged and Supportive Providers in the HIV Care Experiences of Black Sexual Minority Men Living with HIV

Autor: Kielhold K, Storholm ED, Reynolds HE, Vincent W, Siconolfi DE, Kegeles SM, Pollack L, Campbell CK
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Patient Preference and Adherence, Vol Volume 18, Pp 1641-1650 (2024)
Druh dokumentu: article
ISSN: 1177-889X
10656421
Popis: Kirstin Kielhold,1,2 Erik D Storholm,2,3 Hannah E Reynolds,2 Wilson Vincent,4 Daniel E Siconolfi,3 Susan M Kegeles,5 Lance Pollack,5 Chadwick K Campbell1 1Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA; 2School of Public Health, San Diego State University, San Diego, CA, USA; 3RAND Corporation, Pittsburgh, PA, USA; 4Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA; 5Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, USACorrespondence: Kirstin Kielhold, School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA, Tel +12093292720, Email kkielhold7624@sdsu.eduBackground: Black sexual minority men (BSMM) in the Southern region of the United States experience a disproportionate burden of HIV. Research findings suggest that having supportive patient-provider relationships are critical for sustained HIV care engagement. The present study explores the role of supportive healthcare providers in the care engagement among BSMM living with HIV (BSMM+) in the US South.Methods: Semi-structured qualitative interviews were conducted with BSMM+ in Texas (n=27) to explore perceived barriers and facilitators of sustained care engagement. Interviews lasted 60 minutes on average, were transcribed, coded, and analyzed using applied thematic analysis.Findings: Participants described how important having relationships with engaged and supportive HIV care and service providers is to sustained engagement in care and positive HIV clinical outcomes. Supportive providers were characterized as non-judgmental, meeting patients’ needs, and making patients feel “seen”. Less supportive providers were described as making their patients “feel like a number” and having lack of follow through on proposed support and resources. Supportive providers were associated with increased care engagement of their patients while less supportive providers often led to patients switching providers, losing touch with services, and getting off track with their care.Discussion: We found that among BSMM+ an important facilitator of sustained care engagement was having positive, affirming, and knowledgeable healthcare providers, while negative and dismissive experiences with providers was a notable barrier to care engagement. This work highlights the need for a scale up of comprehensive, ongoing trainings in patient-centered and person-first communication for providers. Further, manageable provider caseloads can facilitate more thorough patient interactions where tailored HIV care and education can be provided in a safe and non-judgmental environment.Plain Language Summary: Black sexual minority men in the Southern region of the United States experience a disproportionate burden of HIV. While the role of patient-provider relationships for HIV care engagement has been shown in some contexts, less is known about the specific role of supportive healthcare providers in the care engagement among Black sexual minority men living with HIV in the United States South.Semi-structured qualitative interviews were conducted among Black sexual minority men living with HIV in Texas (n=27) to explore perceived barriers and facilitators of sustained care engagement.We found that supportive providers were associated with increased care engagement of their patients while less supportive providers often led to patients switching providers, losing touch with services, and getting off track with their care. Our findings suggest the need for a scale up of comprehensive, ongoing trainings in patient-centered and person-first communication for providers.Keywords: HIV, black sexual minority men, care engagement, patient-provider relationship
Databáze: Directory of Open Access Journals
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