Service providers’ perspectives on facilitators and recommendations for improving HIV care in Manitoba, Canada
Bibliographic record
Abstract
Background: We aimed to identify facilitators and recommendations for improving HIV care in Manitoba, Canada from service providers' perspectives. Methods: This study is a component of a participatory action research study examining the interrelatedness of houselessness, substance use and other factors on HIV care. We conducted in-depth, semi-structured interviews with 27 HIV service providers in Manitoba (Canada). Interviews were transcribed, coded, and analyzed using a thematic approach within a socio-ecological framework. Results: We identified 11 supertheme facilitators and 15 supertheme recommendations at the intrapersonal, interpersonal, socio-cultural, institutional and structural levels. For the facilitators, subthemes include non-judgmental care (intrapersonal), focus on building relationships and trust (interpersonal), collaboration with other providers (socio-cultural), safe non-stigmatizing environments (institutional), and effective policies (structural). Provider recommendations highlight the need for structural changes, with subthemes focused on policy changes, adaptations to HIV care delivery model, harm reduction strategies, and addressing gaps in social services and mental health care. Conclusion: Service providers' behaviours and attitudes as well as organizational processes play a significant role in PLHIV engagement and retention in HIV care. Institutional and structural changes, including flexible and mobile HIV care as well as integrated HIV and harm reduction care, are critical for increasing care uptake and retention.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.023 | 0.006 |
| Scholarly communication | 0.005 | 0.001 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".