IMPROVING HIV TREATMENT PROGRAM ADHERENCE IN AN ETHNICALLY DIVERSE URBAN CLINIC

Antiretroviral treatment in individuals infected with HIV is effective in increasing life expectancy beyond the known natural course of the disease. People who are HIV positive are likely to conceal their status, especially those from cultures that emphasize specific gender roles regarding sexuality. Fear of discovery and secrecy increases the risk of HIV transmission and interferes with patients seeking and adhering to treatment regimens. This descriptive study used semi-structured interviews with care providers to gather information regarding factors that contributed to non-adherence to HIV treatment regimens, and strategies they employed to increase the rate of HIV treatment adherence. Social cognitive theory and the logic model were the conceptual frameworks used to guide the project. Participants included 12 ethnically diverse care providers between the ages of 28 to 62 years from three HIV treatment clinics. Themes identified as contributing to poor treatment adherence were mental health status, homelessness, and stigma related to a positive HIV status. Healthcare system barriers related to the lack of cultural diversity among providers, bureaucratic issues relating to insurance coverage, and limited access to specialized services. This doctor of nursing practice project demonstrated the need for further investigation on how factors within the healthcare system affect HIV treatment adherence. Another need is to evaluate the effectiveness of assessment tools used to identify clients at high risk for treatment non-adherence