"I'm in the Care Orbit": Unveiling the Enabling Context of the HIV Care Continuum in People Living With HIV

Abstract

This study aimed to explore the enabling context of the HIV care continuum as perceived by people living with HIV and healthcare professionals. This qualitative study involved in-depth individual interviews with eight people living with HIV and group interviews with seven nurses and physicians. These interviews took place between March 5, 2021, and July 13, 2022. Thematic analysis was conducted. The main themes that emerged included “network of support and systems,” “personal gains from the care continuum,” “continuity and practicality of healthcare services,” “presence of significant other(s),” and “social belonging.” These themes were structured within the five levels of the socio-ecological model (system, individual, organizational, interpersonal, and community levels), and 10 subthemes were identified. With the integration of themes, the enabling context was compared to a “care orbit,” indicating that people diagnosed with HIV start treatment at the system level and continue HIV care at other levels. In addition to primary support at the system level, the enabling context also includes individual commitment to care and regular health habits, hospital services, support from significant others, and community culture. Together, the context helps guide people living with HIV into the “orbit” of the care system.