Multilevel factors influencing HIV care and management in the Deep South: insights from HIV care professionals

Authors

• Irvin Ong, Columbia University School of Nursing, New York, NY
• Maeve Brin, Columbia University School of Nursing, New York, NY
• Claudia L. Michaels, Columbia University School of Nursing, New York, NY
• Mary Hripcsak, Columbia University School of Nursing, New York, NY
• Trinity Casimir, Columbia University School of Nursing, New York, NY
• Zoe E. Brown, Columbia University School of Nursing, New York, NY
• Mauda Monger, University of Mississippi Medical Center School of Population Health, Jackson, MS
• Makailya Drake, University of Mississippi Medical Center School of Population Health, Jackson, MS
• Jessica Schwiesow, Unity Wellness Center, Opelika, AL
• Tracy Wynne, Unity Wellness Center, Opelika, AL
• Dylan B. Yates, Tulane University School of Social Work, New Orleans, LA
• Sekiyah Jackson, Health Services Center, Anniston, AL
• Kelly Turner, Health Services Center, Anniston, AL
• Meredith E. Clement, LSU Health Sciences Center – New OrleansFollow
• Clare Kelsey, LSU Health Sciences Center – New OrleansFollow
• Corina T. Lelutiu-Weinberger, Columbia University School of Nursing, New York, NY
• Audrey Hang Hai, Tulane University School of Social Work, New Orleans, LA
• D Scott Batey, Tulane University School of Social Work, New Orleans, LA
• Rebecca Schnall, Columbia University School of Nursing, New York, NY

Document Type

Article

Publication Date

8-24-2026

Publication Title

AIDS Care

Abstract

The United States Deep South bears a disproportionate HIV burden, with low rates of retention in care and viral suppression among people living with HIV (PWH). Factors influencing HIV care engagement can be understood through the modified social ecological model (MSEM), which comprises five interconnected layers: individual, network, community, policy, and HIV epidemic stage. We interviewed thirty HIV care professionals from Alabama, Mississippi, and Louisiana to identify optimal, culturally relevant approaches for engaging PWH in care.

Using MSEM for qualitative analysis, we identified salient factors affecting HIV care engagement including spirituality, stigma, medical trust, wellness, risk perception, structural barriers, technology, social and sexual networks, clinic characteristics, HIV awareness, access to education, testing, PrEP, social assistance, and federal, statewide, and insurance policies. Our findings outline areas for organizational, community-level, and policy changes to improve health outcomes including implementing holistic care in HIV clinics that addresses socioeconomic barriers through public funding mechanisms, expanding sex education beyond abstinence-only curricula, promoting HIV education and testing within faith-based settings, and ensuring Medicaid coverage of low-income PWH to support medication adherence and viral suppression. By centering insights of those delivering and coordinating care, this study provides practical guidance for guiding interventions toward national goals.

First Page

2322

Last Page

2337

PubMed ID

42635478

Volume

38

Rights

© 2026 Informa UK Limited, trading as Taylor & Francis Group

Recommended Citation

Ong, Irvin; Brin, Maeve; Michaels, Claudia L.; Hripcsak, Mary; Casimir, Trinity; Brown, Zoe E.; Monger, Mauda; Drake, Makailya; Schwiesow, Jessica; Wynne, Tracy; Yates, Dylan B.; Jackson, Sekiyah; Turner, Kelly; Clement, Meredith E.; Kelsey, Clare; Lelutiu-Weinberger, Corina T.; Hai, Audrey Hang; Batey, D Scott; and Schnall, Rebecca, "Multilevel factors influencing HIV care and management in the Deep South: insights from HIV care professionals" (2026). School of Medicine Faculty Publications. 5241.
https://digitalscholar.lsuhsc.edu/som_facpubs/5241
10.1080/09540121.2026.2708429