| Learning Objective #1: Identify factors associated with retention in HIV-oriented primary medical care | |||
| Learning Objective #2: Utilize a screening algorithm to determine risk of non-retention in HIV-oriented primary medical care to clinical practice |
Design/Methods/Variables: Using a retrospective predictive, correlational design combined with grounded theory interviews, demographic correlates associated with retention in HIV-oriented primary care as well as the processes and factors of health care seeking behaviors were examined.
Sample: Participants in this study were individuals who voluntarily enrolled in HIV-oriented medical care at a large urban HIV clinic. During the last six months of 2001, 161 new patients voluntarily enrolled in HIV-oriented primary care. These patients were followed for 18 months and then classified as regular users, sporadic users, or non-engagers. Among the regular and sporadic users, qualitative interviews were conducted until theoretical saturation was identified.
Findings/Conclusions: Qualitatively, individuals have “stigmas” and “obstacles” to overcome in order to be “connected” to the health system. Additionally, “health literacy” was critical in facilitating life mastery leading to regular engagement in care. Quantitatively, three variables predicted retention in HIV-oriented primary medical care. These three variables, race/ethnicity, years clean from drugs, and employment status, yielded a predictive model that was highly sensitive and specific.
Implications for Nursing Practice: Results of this study were used to develop an algorithm to screen for high-risk of non-retention in HIV-oriented primary medical care for new clients. Based on findings from this study, a model of care was designed to promote retention in care among new clients identified to be at high-risk of dropping out or sporadic use.