Can Community Health Workers in Miami Disrupt Disparities among Black People Living with HIV: A Qualitative Analysis

Abstract

Aims This study aims to understand how clinic-based Community Health Workers could address barriers to viral suppression and improve HIV management among Black people living with HIV. Background South Florida is home to the greatest number of people living with HIV (PLH) in Florida, and Black communities are disproportionately impacted. Among the most promising strategies to improve HIV outcomes among Black PLH (BPLH) are Community Health Worker (CHW) interventions. Traditionally, CHWs assist PLH in non-clinical environments, and little data exists on the effects of CHW strategies in clinical settings. Methods From March 2021 to January 2022, we administered semi-structured interviews to patients, caregivers, and clinic staff to assess their perceptions of barriers to HIV care, facilitators of HIV care, and views on CHWs using a rapid qualitative analysis framework. Results There was significant overlap between clients and providers regarding the perceived barriers and facilitators to HIV care. Emergent themes reflected concepts surrounding HIV policy and clinic limitations, stigma across clinic- and community-based settings, and suggestions on ways CHWs can address these concerns. Conclusion The results suggest embedding CHWs into HIV clinical teams may be an efficacious approach to address unmet social needs and overcome systemic barriers to HIV care, leading to improved care engagement and HIV outcomes among BPLH.