Healthcare Provider Strategies and Approaches to Supporting People Living With HIV Who Are Experiencing HIV Treatment Disengagement in British Columbia, Canada

We conducted a strengths-based, qualitative study to elucidate the approaches and strategies utilized by healthcare providers (HCPs) to support HIV treatment engagement in British Columbia (BC), Canada. Healthcare providers (e.g., nurses, peer navigators, and pharmacists) across the province of BC were recruited through regional HIV programs and by word of mouth through purposive sampling strategies. An academic and community researcher co-conducted semi-structured phone interviews with HCPs providing HIV-specific healthcare. Emergent coding and participatory analysis, guided by interpretive description and the socio-ecological model, were used to uncover themes. Across all provincial health regions, 19 HCPs were interviewed between November 2020 and May 2021. Narratives centered around HIV care as a relational practice and the importance of person-centered care approaches. HCPs underscored the need to foster long-term, trusting relationships with clients, founded on respect, compassion, and non-judgmental approaches, which acknowledged the unique care engagement needs and experiences of people living with HIV (PLWH) experiencing treatment breaks. Successful engagement approaches supported clients' overall stability, which directly support treatment adherence. This includes strategies tailored to address unique client contexts and priorities related to psychosocial and other intersecting health needs. Collaborative relationships with other providers, both formal multidisciplinary team-based care and partnerships with ancillary service staff, were found to improve care continuity. Our study highlights the importance of relationship-building, person-centered care, and collaborative care to support PLWH experiencing breaks in treatment. HIV HCPs emphasized holistic, community-centered approaches as crucial to successful and long-term engagement of PLWH in care.