Barney, D., Barile, J., Pruitt, A., Chow, D., & Shikuma, C.
American Public Health Association Annual Meeting & Expo, San Diego, C.A., November 2018
Publication year: 2018

Individuals not engaged in HIV treatment are more likely to come from disadvantaged backgrounds, experiencing difficulties across several life domains that may make any treatment engagement challenging. In Hawai‘i, Native Hawaiians are particularly vulnerable to treatment loss and these disadvantages. Our study identified individual vulnerabilities to re-engagement in HIV treatment and barriers against/protective factors to maintaining treatment for people living with HIV (PLWHIV) who have fallen out of care on O‘ahu, HI. This presentation will discuss these findings and suggest ways to improve care. methods: We present findings from an ongoing mixed methods investigation of a case management intervention aimed at re-engaging PLWHIV who have fallen out of care. An intensive case management program was introduced to individuals (n=25) with a history of HIV treatment noncompliance and chronically detectable viral loads (VL > 200). All individuals were surveyed and interviewed by study staff every other month to identify barriers, protective factors, and methods to best meet clients’ individual needs. results: Based on one-to-one qualitative interviews and service utilization records, we found that instability in housing, employment, transportation, social support, and mental health services were associated with difficulties engaging in treatment integration and that these issues often prevented later re-engagement. Preliminary findings suggest that individuals who have received case management and reengaged in HIV care have benefited from increased stability of these life dimensions, with increased HIV education as an emergent protective factor. conclusions: Preliminary findings suggest that interventions that target these barriers encourage retention and re-engagement in HIV care.