PhD, University of Cincinnati, 2015, Nursing: Nursing - Doctoral Program

Background: Despite tremendous advances in HIV treatment, less than 30% of the more than 1 million people living with HIV in the US are achieving optimal treatment outcomes. Researchers have recognized that there is an urgent need to understand factors and processes that influence individuals with HIV to initiate HIV care. Purpose: The specific aims of the study were to develop a theoretical framework to explain the psychosocial process of care initiation in individuals living with HIV to identify the critical junctures, defined as pivotal events reported by study participants, that influence individuals living with HIV in their decision to initiate HIV care Methods: Grounded theory was the method used to analyze in-depth interviews with individuals living with HIV. A team of IRB-approved researchers analyzed the data using three levels of coding: Open coding, selective coding, and theoretical coding. Analysis was conducted with an aim of identifying the psychosocial process of care initiation by individuals living with HIV. Results: 30 individuals living with HIV (28 men, 2 women) participated in the study. Participants shared their stories about how they went from learning that they had HIV to the point of HIV care initiation. The core category discovered in the data was concept of HIV as news. News, by definition, is impactful information that was not previously known that is delivered by one party and received by another. Participants described a process in which they progressed through five distinct stages: a) receiving the news, b) interpreting the news, c) incorporating the news, d) acting on the news, and e) moving beyond the news. Each stage was moderated by influential factors including perceived susceptibility to HIV infection, symptoms, HIV information, and feedback from others. The initial receipt of the news was typically interpreted as `bad news'. However, through reflection, interaction with others, and information seeking, participants l (open full item for complete abstract)

Committee: Donna Martsolf Ph.D. R.N. (Committee Chair); Judith Feinberg M.D. Ph.D. (Committee Member); Donna Shambley-Ebron Ph.D. (Committee Member) Subjects: Nursing