Retention in hiv care in Australia: The perspectives of clinicians and clients, and the impact of medical and psychosocial comorbidity

Bulsara, SM; Wainberg, ML; Audet, CM; Newton-John, TRO

Retention in hiv care in Australia: The perspectives of clinicians and clients, and the impact of medical and psychosocial comorbidity

Bulsara, SM

Wainberg, ML Audet, CM Newton-John, TRO

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Publication Type:: Journal Article
Citation:: AIDS Patient Care and STDs, 2019, 33 (10), pp. 415 - 424
Issue Date:: 2019-10-01

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Field	Value	Language
dc.contributor.author	Bulsara, SM https://orcid.org/0000-0002-2015-853X	en_US
dc.contributor.author	Wainberg, ML	en_US
dc.contributor.author	Audet, CM	en_US
dc.contributor.author	Newton-John, TRO https://orcid.org/0000-0003-4219-4985	en_US
dc.date.issued	2019-10-01	en_US
dc.identifier.citation	AIDS Patient Care and STDs, 2019, 33 (10), pp. 415 - 424	en_US
dc.identifier.issn	1087-2914	en_US
dc.identifier.uri	http://hdl.handle.net/10453/137331
dc.description.abstract	© Copyright 2019, Mary Ann Liebert, Inc., publishers 2019. Significant advances in our understanding and treatment of HIV have led to improvements in the medical management of the illness, as HIV infection has evolved from an acute to a chronic illness. Increasing our understanding of the medical and/or psychosocial comorbidities, which can interact to determine "clinical complexity" and impact HIV management, will further strengthen this process. Retention in care is a critical step of the HIV Treatment Cascade, which facilitates effective management of these comorbidities and their impact on HIV medical management. This study sought to build on literature regarding medical and/or psychosocial comorbidity that impacts retention in care, and it often leads to clinically complex presentations, by gaining the perspectives of people living with HIV (PLHIV), and medical and allied health clinicians in the field in Sydney, Australia. A total of 16 clinicians (medical doctors, nurses, clinical psychologists, and social workers) and 14 clients participated in a series of focus groups; they were asked to comment on the perceived barriers to retention and the potential solutions to overcome these. The results indicated a significant degree of overlap between clinician and client perspectives, and they identified "service-specific factors," "logistic/practical factors," "medical/physical factors," and "psychosocial factors" as potential barriers to retention. Results are reviewed in the context of similarities and differences in perspectives between clinicians and PLHIV, and limitations regarding the generalizability of findings are discussed. The broader context of comorbidity and clinical complexity is also examined.	en_US
dc.relation.ispartof	AIDS Patient Care and STDs	en_US
dc.relation.isbasedon	10.1089/apc.2019.0094	en_US
dc.subject.classification	Virology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	HIV Infections	en_US
dc.subject.mesh	Focus Groups	en_US
dc.subject.mesh	Attitude of Health Personnel	en_US
dc.subject.mesh	Health Knowledge, Attitudes, Practice	en_US
dc.subject.mesh	Mental Disorders	en_US
dc.subject.mesh	Comorbidity	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Health Personnel	en_US
dc.subject.mesh	Health Services Accessibility	en_US
dc.subject.mesh	Patient Acceptance of Health Care	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Interviews as Topic	en_US
dc.subject.mesh	Social Stigma	en_US
dc.subject.mesh	Retention in Care	en_US
dc.title	Retention in hiv care in Australia: The perspectives of clinicians and clients, and the impact of medical and psychosocial comorbidity	en_US
dc.type	Journal Article
utslib.citation.volume	10	en_US
utslib.citation.volume	33	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
utslib.copyright.status	closed_access
pubs.issue	10	en_US
pubs.publication-status	Published	en_US
pubs.volume	33	en_US

Abstract:

© Copyright 2019, Mary Ann Liebert, Inc., publishers 2019. Significant advances in our understanding and treatment of HIV have led to improvements in the medical management of the illness, as HIV infection has evolved from an acute to a chronic illness. Increasing our understanding of the medical and/or psychosocial comorbidities, which can interact to determine "clinical complexity" and impact HIV management, will further strengthen this process. Retention in care is a critical step of the HIV Treatment Cascade, which facilitates effective management of these comorbidities and their impact on HIV medical management. This study sought to build on literature regarding medical and/or psychosocial comorbidity that impacts retention in care, and it often leads to clinically complex presentations, by gaining the perspectives of people living with HIV (PLHIV), and medical and allied health clinicians in the field in Sydney, Australia. A total of 16 clinicians (medical doctors, nurses, clinical psychologists, and social workers) and 14 clients participated in a series of focus groups; they were asked to comment on the perceived barriers to retention and the potential solutions to overcome these. The results indicated a significant degree of overlap between clinician and client perspectives, and they identified "service-specific factors," "logistic/practical factors," "medical/physical factors," and "psychosocial factors" as potential barriers to retention. Results are reviewed in the context of similarities and differences in perspectives between clinicians and PLHIV, and limitations regarding the generalizability of findings are discussed. The broader context of comorbidity and clinical complexity is also examined.

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http://hdl.handle.net/10453/137331