Understanding the Behavioral Determinants of Retention in HIV Care: A Qualitative Evaluation of the Situated Information, Motivation, Behavioral Skills model of Care Initiation and Maintenance
The goal of this study is to identify the content and context of critical informational, motivational, and behavioral skills related facilitators and barriers influencing retention in HIV care in an inner-city clinic population receiving clinic- and outreach-based HIV care services. Elicitation of retention-relevant factors was guided by the Situated Information-Motivation-Behavioral Skills model of Care Initiation and Maintenance, using qualitative in-depth semi-structured interviews. Deductive and inductive content coding were used to identify important theory-based dynamics of retention in HIV care and to identify factors discussed as important to retention in HIV-care that were not well specified by the model. Participants’ experiences with retention in HIV care were well characterized by the proposed information, motivation, and behavioral skill model components. Findings indicate a need to attend to multiple determinants of self-directed care attendance, including information, motivation, and behavioral skills, as critical to sustaining retention in care over time. Contextual factors related to living with HIV including acceptance of diagnosis, HIV stigma and HIV-related physical and cognitive impairments; as well as those highly relevant to a marginalized inner-city population, such as care attendance and patient-provider relationships in the context of ongoing depression or active substance use additionally comprise aspects of these IMB-based determinants of retention in HIV care.
HIV care, retention, health behavior models
Networked Digital Library of Theses and Dissertations