Reaching and Re-Engaging People Living with HIV Who Are Out of Care: A Mixed-Methods Exploration of Patient Preferences for Strategies to Enhance Clinic Communication and Outreach

Abstract

Half of all people living with HIV (PLWH) in the United States are not retained in HIV medical care. The utility of appointment reminders and clinic-based retention support services is often limited by the inability to contact PLWH who are out of care (PLWH-OOC) due to disconnected phone lines, full voice mails, and housing instability. Between June 2019 and May 2021, as part of a larger mixed-methods study in Metro Atlanta, Georgia, we conducted surveys with 50 PLWH-OOC and interviews with 13 PLWH holding a variety of clinic stakeholder roles (patients, Community Advisory Board members, and peer navigators) to explore preferences for clinic communication and peer outreach and factors impacting uptake. Although phone calls, text messages, and calling secondary contacts were most preferred, the spread of preferences was wide. Surveys and interviews highlighted the high acceptance of peer outreach visits, with trust, support, and privacy being key factors driving the uptake. Findings underscore the need for clinics to offer a suite of communication and outreach strategies and assess patient preferences for traditional and nontraditional outreach models to more effectively reach, re-engage, and ultimately retain PLWH-OOC.