Positive Influences: How Provider Actions Affect HIV Care Engagement for Black Women in the Southwest U.S.

Despite medical advances having made HIV a survivable condition, HIV persists as the 11th leading cause of death among young Black women. Enhancing the quality of care engagement through beneficial patient-provider relationships can close gaps in retention and adherence, enabling long, healthy lives. Using constructivist grounded theory informed by an established framework for patient-centered care in complex cancer settings and insight from local HIV advocates, this work identifies what provider actions retain women in care and why. Through focus groups and interviews, eleven Black women in the Southwestern United States, an understudied population, express that providers who engage them as co-creators in maintaining good health are more likely to retain them. Concurrently, when women are attuned to their own health care and interpersonal needs, they discern which providers are equally committed to their health based upon observed provider actions. These actions, such as listening attentively, taking time, and paying attention to the whole person, in conjunction with women's motivation and active involvement, create a reciprocal dynamic that increases the likelihood these women will remain virally suppressed. The ideal relationship is one in which the provider empowers and champions women as drivers of their own care.