Journal of the Association of Nurses in AIDS Care· 2026Q1
Multilevel Barriers and Facilitators to HIV Care Engagement Among Virally Unsuppressed People Living With HIV in the U.S. Deep South: A Qualitative Study
- 1citations
- Q1SCImago
- 2026year
Short summary
Qualitative interviews with 30 virally unsuppressed people living with HIV in the U.S. Deep South revealed that financial insecurity, transportation, depression, and stigma are key barriers to care engagement, while holistic, confidential clinic services can be facilitators.
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Key points
- Financial insecurity, transportation challenges, depression, and internalized stigma are major barriers to HIV care engagement for virally unsuppressed individuals in the U.S. Deep South.
- Social networks can be both supportive and a source of stigma, particularly within family and faith-based contexts.
- Clinics providing confidential, holistic services that address social needs are critical facilitators of care engagement.
- Persistent discrimination, restrictive policies, and HIV criminalization further hinder engagement with HIV care.
AI-generated from the title and abstract; the full text is not read.
Abstract
ABSTRACT: The U.S. South experiences disproportionate HIV-related morbidity and persistently lower viral suppression rates. Achieving Ending the HIV Epidemic goals requires understanding multilevel influences on care engagement among virally unsuppressed people living with HIV. We conducted in-depth qualitative interviews with 30 virally unsuppressed people living with HIV receiving care across Alabama, Louisiana, and Mississippi. Guided by the Modified Social Ecological Model, we examined individual, interpersonal, clinic, community, and policy-level factors shaping engagement and antiretroviral therapy adherence. Participants described intersecting structural and psychosocial barriers, including financial insecurity, transportation challenges, depression, and internalized stigma. Social networks functioned as both support and stigma, particularly within family and faith contexts. Clinics served as critical anchors when providing confidential, holistic services addressing social needs, although inefficiencies and resource constraints disrupted continuity. Persistent discrimination, restrictive policies, funding instability, and HIV criminalization further threatened engagement, underscoring the need for multilevel interventions to improve viral suppression.
The authors' abstract, as published at the source. Journal of the Association of Nurses in AIDS Care, 2026 · DOI ↗
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Field: Infectious Diseases
Infectious DiseasesMedicine