ArticleBMC research notes2016
A qualitative study of barriers to and facilitators of optimal engagement in care among PLWH and substance use/misuse.
Article in BMC research notes, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Promoting HIV care continuum outcomes among people who use drugs and alcohol: a systematic review of randomized trials evaluating behavioral HIV care interventions published from 2011 to 2023.BMC public health · 2023Pooled it
- A client-centered relational framework on barriers to the integration of HIV and substance use services: a systematic review.Harm reduction journal · 2019Pooled it
- Strategies to increase attendance in substance use disorder group treatment: results from a randomized controlled trial.Harm reduction journal · 2026Trial
- The roles of heavy drinking and drug use in engagement in HIV care among hospitalized substance using individuals with poorly controlled HIV infection.Drug and alcohol dependence · 2019Trial
- Alcohol and other drug use among HIV-affected adolescents and young adults in Zambia: a qualitative study of multilevel drivers and preferences for prevention and treatment approaches.SSM. Mental health · 2026Article
- A History of Methamphetamine Use Disorder in People with HIV Is Associated with Altered Functional Response to Risky Choice.Viruses · 2026Article
- Barriers and facilitators of ongoing engagement in substance use treatment programmes among people with HIV in South Africa: A qualitative analysis.Southern African journal of HIV medicine · 2026Article
- Adaptive coping, emotions, and antiretroviral therapy adherence among gay, bisexual, and other men who have sex with men (gbMSM) with HIV.Journal of health psychology · 2025Article
- Dual cross-sectional and longitudinal perspective on the continuum of HIV care to disentangle natural epidemic evolution from real progress, Belgium 2014-2022.HIV medicine · 2025Article
- Who could benefit the most from long-acting antiretroviral therapy? perspectives of HIV care providers and people with HIV in Florida.AIDS care · 2025Article
- Gender and Intersecting Barriers and Facilitators to Access the HIV Cascade of Care in Manitoba, Canada, Before and During the COVID-19 Pandemic: A Qualitative Study.Tropical medicine and infectious disease · 2024Article
- Avoidance and Rumination as Predictors of Substance Use, Mental Health, and Pain Outcomes Among People Living With HIV.Behavior therapy · 2024Article
- Use of poppers (nitrite inhalants) among young men who have sex with men with HIV: A clinic-based qualitative study.BMC public health · 2024Article
- Understanding why racial/ethnic inequities along the HIV care continuum persist in the United States: a qualitative exploration of systemic barriers from the perspectives of African American/Black and Latino persons living with HIV.International journal for equity in health · 2023Article
- A Digital Counselor-Delivered Intervention for Substance Use Among People With HIV: Development and Usability Study.JMIR formative research · 2023Article
- Trajectories of re-engagement: factors and mechanisms enabling patient return to HIV care in Zambia.Journal of the International AIDS Society · 2023Article
- Differential Effects of Patient Navigation across Latent Profiles of Barriers to Care among People Living with HIV and Comorbid Conditions.Journal of clinical medicine · 2022Article
- Shifting the narrative: equity, evidence, effectiveness, and innovation in the era of Ending the HIV Epidemic.International journal for equity in health · 2022Article
- The Boundary of HIV Care: Barriers and Facilitators to Care Engagement Among People with HIV in the United States.AIDS patient care and STDs · 2022Article
- Injection and Non-Injection Drug Use Among Adults with Diagnosed HIV in the United States, 2015-2018.AIDS and behavior · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundPersons living with HIV (PLWH) and substance use/misuse experience significant barriers to engagement in HIV care at every step of the HIV care continuum including: (1) HIV testing and diagnosis (2) linkage to clinical care (3) retention in care pre-antiretroviral therapy (ART) (4) ART initiation and adherence (5) viral suppression. We qualitatively explored the facilitators of and barriers to participation in the HIV care continuum among PLWH with substance use/misuse.
methodsWe performed semi-structured in-depth interviews with 34 PLWH in care with recent substance use. The transcripts were analyzed in an iterative process using an editing style analysis. Interviews were conducted until thematic saturation was achieved.
resultsParticipants attributed an escalation in drug use at the time of diagnosis to denial of their disease and the belief that their death was inevitable and cited this as a barrier to treatment entry. In contrast, participants reported that experiencing adverse physical effects of uncontrolled HIV infection motivated them to enroll in care. Reported barriers to retention and adherence to care included forgetting medications and appointments because of drug use, prioritizing drug use over HIV treatment and side effects associated with medications. Participants described that progression of illness, development of a medication taking ritual and a positive provider-patient relationship all facilitated engagement and reengagement in care.
conclusionsPLWH with substance use engaged in care describe barriers to and facilitators of optimal engagement related to and distinct from substance use. Greater understanding of the biologic, psychological and social factors that promote and impair engagement in care can inform interventions and reduce the increased morbidity and mortality experienced by PLWH with substance use.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.