Couple-centered HIV prevention and care: Endorsement, practice and uncertainty among us healthcare providers in western-central upstate New York.

Abstract

Given the influence of provider perspective and practice in the uptake of HIV/STI prevention and care strategies, this qualitative descriptive design study sought to illuminate perspectives of couples HIV testing and counseling (CHTC) and describe couple/partner-based practices among health providers in New York State. We utilized a purposive sampling strategy to recruit health providers (N = 27). Semi-structured in-depth interviews were conducted from Sept. 2019 to Feb. 2021. Four themes emerged: perspectives on engaging partners and couples-centered sexual health promotion; providers' experiences with patients and partners in HIV prevention and care; provider endorsement of CHTC; and perceived CHTC implementation determinants. CHTC endorsement was prominently due to the perception of CHTC as a facilitator to enhance patient-provider engagement in HIV/STI treatment and care, especially in the communication and dissemination of information among partners. Providers reported that health literacy needs regarding HIV/STI testing and diagnosis, but primarily STIs treatment regimens warranted a joint approach. CHTC endorsement entailed the strategy's perceived ability to enhance sexual health literacy among patients and patient's partners. Lastly, CHTC endorsements entailed provider beliefs that it ensured knowledge equity and joint literacy in the communication of health information among health consumers. Determinants of CHTC implementation were factors that providers perceived to have a bearing on the facilitation or posed as barriers to jointly engage partners in HIV/STI prevention and care and was subsequently a source of provider uncertainty. These determinants ranged from provider-level factors to organizational capacity issues that could impact CHTC implementation. Recommendations for CHTC are discussed.