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AIDS and Behavior

, Volume 23, Issue 4, pp 900–907 | Cite as

Making the Link: A Pilot Health Navigation Intervention to Improve Timely Linkage to Care for Men Who have Sex with Men and Transgender Women Recently Diagnosed with HIV in Guatemala City

  • M. Itzel Loya-Montiel
  • Dirk A. Davis
  • Jose Manuel Aguilar-Martínez
  • Olga Alicia Paz Bailey
  • Sonia Morales-Miranda
  • Juan Pablo Alvis-Estrada
  • Sanny Northbrook
  • Clare BarringtonEmail author
Original Paper

Abstract

We piloted a health navigation strategy to promote timely linkage to care among men who have sex with men (MSM) and transgender women (TW) recently diagnosed with HIV in Guatemala City. We used a mixed-methods approach, integrating quantitative data collected during clinic visits and qualitative data from in-depth interviews, to characterize acceptability of navigation and time to linkage, defined as having the first clinical care visit. Out of 54 participants who enrolled in the pilot (n = 52 MSM; n = 2 TW), 50 (92.6%) accepted navigation and all were linked to care. Median time to linkage was 3 days (Interquartile Range 2–5 days). In qualitative interviews, participants expressed feeling scared and alone following their diagnosis and appreciated the support of a navigator, especially when they did not feel they could access their existing support networks. Future research and evaluation should continue to assess how to best use health navigation to support key populations recently diagnosed with HIV.

Keywords

HIV MSM Health navigation Linkage to care Guatemala 

Resumen

Piloteamos una estrategia de navegación en salud para mejorar la vinculación oportuna a la atención de hombres que tienen sexo con hombres (HSH) y de  mujeres transgénero (MT) recién diagnosticados con VIH en la Ciudad de Guatemala. Utilizamos una estrategia de métodos mixtos. Integramos datos cuantitativos recopilados durante visitas a las clínicas y datos cualitativos de entrevistas en profundidad, para caracterizar la aceptabilidad de la navegación y el tiempo de vinculación, definido como haber asistido a la primera consulta de atención clínica. De los 54 participantes enrolados en el pilotaje (n = 52 HSH; n = 2 MT), 50 participantes (92.6%) aceptaron la navegación y todos fueron vinculados a la atención. La mediana del tiempo de vinculación fue de 3 días (rango intercuartílico 2–5 días). En las entrevistas cualitativas, los participantes expresaron sentirse asustados y solos después de recibir el diagnóstico y agradecieron el apoyo de un navegador, especialmente cuando sentían que no podían acceder a sus redes existentes. Investigaciones y evaluaciones futuras deberían continuar explorando el uso de la navegación en salud con poblaciones clave recientemente diagnosticadas con VIH.

Notes

Acknowledgements

This study was supported by the Presidential Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention, under the terms of Cooperative Agreement GH0000575. The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention. We are grateful to the study participants for sharing their experiences with us and to the study team and community partners for their professionalism and commitment.

Funding

This study was supported by the Presidential Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention (CDC), under the terms of Cooperative Agreement GH0000575. The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the funding agencies.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • M. Itzel Loya-Montiel
    • 1
  • Dirk A. Davis
    • 2
  • Jose Manuel Aguilar-Martínez
    • 1
  • Olga Alicia Paz Bailey
    • 4
  • Sonia Morales-Miranda
    • 5
  • Juan Pablo Alvis-Estrada
    • 1
  • Sanny Northbrook
    • 3
  • Clare Barrington
    • 2
    Email author
  1. 1.HIV Central America Regional Program, Center for Health StudiesUniversidad del Valle de GuatemalaGuatemala CityGuatemala
  2. 2.Department of Health Behavior, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillUSA
  3. 3.U.S. Centers for Disease Control and Prevention (CDC) Central America RegionGuatemala CityGuatemala
  4. 4.Center for Conflict, Power and Violence Studies - CENDESGuatemala CityGuatemala
  5. 5.Consorcio de Investigación sobre VIH, SIDA y TB (CISIDAT)CuernavacaMexico

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