The provider role in client engagement in HIV care

This multisite, qualitative study examined the process by which persons living with HIV/ AIDS ( PLWHA) engage in primary HIV medical care for treatment. Using a grounded theory approach, the analysis of narrative data from semi-structured in-depth interviews with PLWHA ( n = 76) led to the development of a model describing a cyclic process of engaging in - and falling out of - care. Perceptions of the client- provider relationship emerged as a central element of the process by which persons with HIV engaged - or remained - in care. Provider behaviors that were characterized as engaging, validating, and partnering facilitated engagement and retention in care; behaviors described as paternalistic served as barriers to care. Participants indicated that they desired a care partnership with an empathetic provider who had effective communication skills. These findings provide recommendations for health providers to engage and retain hard- to- reach PLWHA in timely and appropriate HIV care and services.