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Publication Profiles

St. Louis Enhancing Engagement and Retention in HIV/AIDS Care (STEER): a participatory intersectional needs assessment for intervention and implementation planning

Citation

Humphries D, Marotta P, Hu Y, et al. St. Louis Enhancing Engagement and Retention in HIV/AIDS Care (STEER): a participatory intersectional needs assessment for intervention and implementation planning. Res Sq. 2024:rs.3.rs-4225131. doi:10.21203/rs.3.rs-4225131/v1

Implementation stage:

Pre-Implementation

Implementation outcomes reported:

Not applicable

Continuum target addressed:

Engagement in treatment (including retention and re-engagement)

Geography:

Missouri

Study Participant Classification:

Recipients of care, Providers, Community member(s)

Plain Language Objectives

The researchers wanted St. Louis community members, workers, and leaders to identify connected barriers that keep people with HIV from care. They used the findings to plan an intervention that addresses structural inequities rather than treating each barrier separately.

Plain Language Abstract

St. Louis includes almost half of Missouri residents living with HIV and has longstanding structural racism and economic inequities that can affect care. An 18-month planning team brought together researchers, a community organization, and community representatives. The needs assessment combined existing data with interviews involving 12 people with HIV, five community leaders, four clinical leaders, three community health workers, three supervisors, and two focus groups with 12 frontline workers. An intersectionality framework guided the questions, interpretation, and planning. Participants identified high provider turnover, weak integration of community health workers into care teams, and organizational difficulty tailoring treatment plans. People with HIV also faced stigma, limited social support, other health conditions, medication side effects, and difficulty meeting basic needs. The planning team concluded that connected, multilevel structural responses may be needed and found the framework useful for community-engaged implementation planning. The study identified needs and shaped a planned intervention; it did not test whether the intervention improved engagement, retention, or viral suppression. Qualitative themes represent participating groups and are not prevalence estimates for all St. Louis residents.

Key Takeaways

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Implementation Science Frameworks

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Community Partnerships

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