Medical College of Wisconsin
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Fostering a "Feeling of Worth" Among Vulnerable HIV Populations: The Role of Linkage to Care Specialists. AIDS Patient Care STDS 2017 Oct;31(10):438-446

Date

10/06/2017

Pubmed ID

28981336

Pubmed Central ID

PMC5650712

DOI

10.1089/apc.2017.0048

Scopus ID

2-s2.0-85037690207   12 Citations

Abstract

To address barriers to adequate engagement in medical care among people living with HIV, Wisconsin's AIDS/HIV Program created a new position, the Linkage to Care (LTC) Specialist. Specialists provide intensive, short-term case management and patient navigation services for small caseloads of individuals at high risk of disengaging with medical care. Clients are eligible if they are newly diagnosed with HIV or new to medical care, recently released from incarceration, recently out of care, nonadherent to scheduled medical care visits, or have detectable viral load while in care. Interviews with 30 clients of Specialists were conducted to understand experiences with the program and medical care. Common themes included the ability of Specialists to navigate complex systems of care and support services, the unique role Specialists played in their clients' lives, and the challenges of transitioning out of the program. Although the primary goal of Specialists is to address barriers to medical care, they often adopted a holistic approach that also included housing, financial assistance, and other social determinants of health. Descriptions of the Specialist's role in implementation manuals focus on their functional roles and the services provided. However, clients often discussed the emotional support they received, especially for clients without strong social support networks. Many clients also desired an ongoing relationship with their Specialists even after discharge, but had been able to establish independence and self-efficacy. The LTC Specialists are resource-intensive considering their small caseloads, but fill an important gap in existing, often overtaxed case management systems.

Author List

Broaddus MR, Owczarzak J, Schumann C, Koester KA

Author

Michelle R. Broaddus PhD Associate Professor in the Psychiatry department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Case Management
Counseling
Emotions
Female
HIV Infections
Humans
Interviews as Topic
Male
Motivation
Patient Discharge
Patient Navigation
Program Evaluation
Qualitative Research
Social Support
Specialization
Vulnerable Populations
Wisconsin