Enhancing value and lowering costs of care: a qualitative exploration of a randomized linkage to care intervention in South Africa

Kriti Jain, Nolundi T. Mshweshwe-Pakela, Salome Charalambous, Tonderai Mabuto, Christopher J. Hoffmann

Research output: Contribution to journalArticlepeer-review

Abstract

While interventions to improve HIV linkage and retention in care exist, none have demonstrated results sufficient to reach UNAIDS 90-90-90 goals. We explored values and costs of seeking clinical care through testing three strategies to improve linkage to care: Point of care CD4 testing alone (POC-CD4), POC-CD4 combined with transportation support and combined with care facilitation. We conducted in-depth interviews with participants and transcribed audio-recordings of care facilitation sessions. Participants described values and costs enhanced or addressed by the three interventions. Psychosocial support provided through the care facilitation intervention appeared salient. Participants named other values and costs of seeking care unrelated to the intervention, such as encouragement from healthcare workers and aversion to lifelong treatment. Combined with the quantitative results of this trial, these findings may point to why the care facilitation arm was successful but not the POC-CD4 only or transportation arms. It also provides guidance for future interventions.

Original languageEnglish (US)
Pages (from-to)481-488
Number of pages8
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume31
Issue number4
DOIs
StatePublished - Apr 3 2019

Keywords

  • HIV continuum of care
  • Linkage to care
  • South Africa
  • mixed methods
  • retention in care

ASJC Scopus subject areas

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health

Fingerprint Dive into the research topics of 'Enhancing value and lowering costs of care: a qualitative exploration of a randomized linkage to care intervention in South Africa'. Together they form a unique fingerprint.

Cite this