Reaching and re-engaging people living with HIV who are out of care: A mixed-methods exploration of strategies to enhance clinic communication and outreach Restricted; Files Only

Abstract

Half of all people living with HIV (PLWH) in the United States are not retained in HIV medical care. Clinics often encounter challenges reaching PLWH who are out-of-care (PLWH-OOC) to remind them of upcoming medical appointments due to factors such as lack of access to a working phone number and unstable housing. This mixed-methods study aimed to describe the preferences of PLWH-OOC for communication and outreach from clinics, as well as to gather perspectives from other clinic stakeholders on how best to reach and engage PLWH-OOC. From June 2019 to May 2021, 50 surveys were conducted with PLWH-OOC and in-depth interviews were conducted with three PLWH-OOC, two PLWH retained in care, six PLWH serving as Ryan White clinic Community Advisory Board members, and 14 HIV clinic staff. Phone calls (58%), text messages (54%), and calling a secondary contact (50%) were the most preferred methods of communication among the 50 survey participants. Three-fifths (60%) felt highly comfortable with a peer navigator visiting them at home or somewhere they hang out. Interviews highlighted trust, privacy, support, and community as considerations in choosing effective communication and outreach methods for better reaching PLWH-OOC. In conclusion, communication and outreach preferences vary at the individual level. Study findings highlight the need for clinics to offer a suite of communication and outreach models to patients at each clinic visit, record their preferences, and utilize this information to more effectively reach, re-engage, and ultimately retain those who are out-of-care.

Table of Contents

Chapter I: Introduction………………………………………....…………………1

Chapter II: Literature Review……………………………………………………..5

Chapter III: Manuscript…………………………………………………...........21

Chapter IV: Conclusion & Recommendations………………………………53

References…………………………………………………………………………..56

Appendix…………………………………………………………………………....62

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palavra-chave	Communication Outreach HIV
Committee Chair / Thesis Advisor	Ameeta Kalokhe, Emory University

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