hiv mapping study - preliminary results: qualitative semi ... · hiv mapping study - preliminary...
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HIV MAPPING Study - Preliminary Results: Qualitative Semi-Structured InterviewsQ. Barnette, B. Witt, M. Coffman, M. Dulin, C. Burns, P. Robinson
In-depth key informant (KI) interviews● To qualitatively characterize barriers to prevention of HIV
and care for people living with HIV in Mecklenburg County.
● Identify key areas to focus future intervention efforts.
BACKGROUND OBJECTIVE METHODS
RESULTS
CONCLUSIONS
Rates of persons living with HIV 2014
AidsVu Map of HIV Prevalence in Meck Co. by Zip Code:PLWH/100,000
HIV epidemic centered in Southeastern USA
● Major cities including Charlotte (Mecklenburg County), NC.
● People living with HIV: 6,232.● 72% men and 28% women.● New diagnoses: 282. ● New diagnoses between 2011 and 2015: 69% Black, 9%
Hispanic/Latino, and 17% White.● Areas of increased prevalence in Meck Co.
In-depth qualitative interviews with 19 KI• July to November, 2017
– HIV Outreach Screeners– Patient Navigators– Case Managers– Ryan White Administration– Epidemiologists– STD Clinic Staff– Physicians– Engaged community members
• Thematic content analysis employed a grounded theoretical approach– NVivo software was used– Team analysis through immersion-crystallization.
• Findings validated via peer debrief
Results: Theme and Subtopic Frequencies are Represented by Relative Polygon Size
Key priorities that emerged– PrEP accessibility– Education and knowledge of HIV– Sensitive and centralized care needed– Social needs such as housing and addressing stigma– Community coordination is imperative.
• Steps to corroborate the data with HIV patient interviews and a subsequent action plan are needed.
Screening & Preventive Care● Need proactive approach to
preventive care● Improvement reaching key
populations● Safe space for LGBTQ+ of
color● Testing Privacy
Communication● Lack of protocol to
achieve rapid linkage to care and support services
● Competition for funding makes for inefficiencies
Concurrent Social Needs● Poverty and transience
main drivers of transmission due to poor access to education, care, and support services
Awareness/Community Education
● Lacking coordination● Lack of inclusive sexual
education/STI prevention ● Misinformation still exists
Behavioral Health● Need patient
self-management and agency within the “continuum of care”
Access● Care centralization and
sensitivity● Lack of transportation● Lack of patient navigation
services● PrEP Accessibility
Structure Design● Testing/counseling/treatmen
t separate & fragmented ● Significant competition for
funding ● Emergency Services
over-utilized
Support Services● Screening privacy is lacking● Do not accommodate a
variety of experiences and identities
Cultural Competency● Medical community
engagement necessary for retention of diverse communities
● Medical mistrust prevalent● Profound generational
differences in urgency
Concurrent Medical Needs● HCV and Syphilis
prevention and treatment are frequent concurrent needs
Funding● Funding for services is
limited and complicated to obtain
● Renewing ADAP services is frequent and may require assistance
● Lack of health insurance is prevalent
“They had no place to receive medicines,
no place to safely store medicines”
“So, the more rapidly these can be condensed – so if testing and counseling and starting all occur at the same time, the closer in proximity those are, the more retention and engagement we have.”
“Housing is a tremendous
issue““a hard time staying compliant”
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