Edinburgh Napier University

  Background/aims: As HIV infection gradually becomes a chronic disease, there is an increased need to provide holistic and person-centered care (PCC) for people living with HIV/AIDS (PLWHA). We therefore developed and tested a community-based enhanced care intervention (CECI) to improve person-centred outcomes for PLWHA. CECI components comprised holistic symptom assessment in the domains of physical, psychological, social, and spiritual wellbeing; collaborative care planning and delivery; and training with mentorship for healthcare professionals (HCP) who delivered CECI. We aimed to describe the experiences of delivering and receiving CECI as well as how this potentially impacted on outcomes and quality of life among PLWHA.
Methods: A cross-sectional qualitative interview was conducted with HCP and PLWHA who delivered and received CECI respectively. Participants were purposively sampled from a feasibility cluster randomised controlled trial cohort and interviews were analysed deductively using thematic analysis.
Results: Of the n=17 participants interviewed, n=10 were PLWHA (median age 39), who received the CECI and n=7 HCP (median age 28) who delivered CECI, with median interview duration of 40 minutes. Five interconnected themes emerged across PLWHA and HCP participants:
(a) relevance of CECI training,
(b) experience of CECI and acceptability,
(c) person-centeredness and quality of life,
(d) communication and care partnership and
(e) time burden and service limitations.
Conclusions: Our data revealed CECI was acceptable to both PLWHA and HCP as it was helpful in broadening the perspectives of HCP to be more holistic in assessing care needs to reflect subsequent care provision, which resulted in unhurried approach with opportunity given to PLWHA to express concerns, influencing potential outcomes reported in the feasibility trial. Time taken to deliver CECI and service limitation were among challenges discussed. Future definitive trial of CECI effectiveness must consider the challenges and process issues reported.