{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T09:05:32Z","timestamp":1784883932785,"version":"3.55.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"NIH","award":["R01AI169602"],"award-info":[{"award-number":["R01AI169602"]}]},{"name":"University of North Carolina at Chapel Hill Center for AIDS Research","award":["P30?AI50410"],"award-info":[{"award-number":["P30?AI50410"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["F31HD114366"],"award-info":[{"award-number":["F31HD114366"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Patient Care and STDs"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:p>Barriers to initiating and maintaining HIV care continue to impede efforts to \u201cEnd the HIV Epidemic\u201d in the United States, particularly among members of Black sexual and gender minoritized (BSGM) groups in the US South. Evidence-informed social network-based interventions may improve engagement in HIV care services among BSGM; however, understanding and addressing context-specific barriers and facilitators to HIV service use are critical for intervention effectiveness. We explored barriers to HIV care engagement to inform the adaptation of a social network strategy to increase participation in HIV prevention and care services in Charlotte, NC. We interviewed BSGM with HIV who were in treatment, local health department officials, clinicians, and community-based organization leaders and held four focus groups (FGs) with HIV public health services staff. Transcripts were iteratively coded and analyzed thematically. We identified two themes across all FGs and in-depth interviews (IDIs). Two additional themes were identified specifically from IDIs with BSGM. Across data sources, participants described multi-level stigma, competing priorities, and logistical hurdles that impede BSGM engagement in HIV care. BSGM with HIV indicated that supportive social networks enhanced HIV treatment adherence and described how their personal agency and self-efficacy evolved after receiving an HIV diagnosis. Interventions to improve HIV care engagement among BSGM with HIV must address inequities, leverage social support networks, and enhance self-efficacy.<\/jats:p>","DOI":"10.1177\/10872914261448349","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T07:01:27Z","timestamp":1778050887000},"page":"307-320","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient and Service Provider Perspectives of Barriers and Facilitators to HIV Care in North Carolina"],"prefix":"10.1177","volume":"40","author":[{"given":"Meagan C.","family":"Zarwell","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Community Health, College of Health and Human Services, UNC Charlotte, Charlotte, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Marin-Cespedes","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Community Health, College of Health and Human Services, UNC Charlotte, Charlotte, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordyn","family":"McCrimmon","sequence":"additional","affiliation":[{"name":"Center for AIDS Research, UNC-Chapel Hill, Chapel Hill, North Carolina, USA."},{"name":"Department of Psychology, College of Humanities and Social Sciences, North Carolina State University, Raleigh, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2771-7214","authenticated-orcid":false,"given":"Marielle","family":"Indyg","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Community Health, College of Health and Human Services, UNC Charlotte, Charlotte, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Dale","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, UNC-Chapel Hill School of Medicine, UNC Chapel Hill Bioinformatics Building, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunice","family":"Okumu","sequence":"additional","affiliation":[{"name":"Center for AIDS Research, UNC-Chapel Hill, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Diggs","sequence":"additional","affiliation":[{"name":"Center for AIDS Research, UNC-Chapel Hill, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse Strunk","family":"Elkins","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Community Health, College of Health and Human Services, UNC Charlotte, Charlotte, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Esposito","sequence":"additional","affiliation":[{"name":"Center for AIDS Research, UNC-Chapel Hill, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ujunwa","family":"Onyeama","sequence":"additional","affiliation":[{"name":"Center for AIDS Research, UNC-Chapel Hill, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Galphin","sequence":"additional","affiliation":[{"name":"Center for AIDS Research, UNC-Chapel Hill, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Golin","sequence":"additional","affiliation":[{"name":"Center for AIDS Research, UNC-Chapel Hill, Chapel Hill, North Carolina, USA."},{"name":"Department of Health Behavior, UNC-Chapel Hill, Gillings School of Global Public, Chapel Hill, North Carolina, USA."},{"name":"Division of General Internal Medicine and Clinical Epidemiology, Department of Medicine, UNC-Chapel Hill School of Medicine, UNC-Chapel Hill, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Zinck","sequence":"additional","affiliation":[{"name":"Center for AIDS Research, UNC-Chapel Hill, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis","family":"Barnes","sequence":"additional","affiliation":[{"name":"Central Piedmont Community College, Charlotte, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keenan","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Community Health, College of Health and Human Services, UNC Charlotte, Charlotte, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, College of Health and Human Services, UNC Charlotte, Charlotte, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann M.","family":"Dennis","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, UNC-Chapel Hill School of Medicine, UNC Chapel Hill Bioinformatics Building, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"e_1_3_6_2_2","unstructured":"Department of Health and Human Services Office of Infectious Disease and HIV\/AIDS Policy. EHE Overview. HIV.gov; 2025. Available from: https:\/\/www.hiv.gov\/federal-response\/ending-the-hiv-epidemic\/overview [Last accessed: August8 2025]."},{"key":"e_1_3_6_3_2","unstructured":"Department of Health and Human Services. U.S. Statistics. HIV.gov; 2025. Available from: https:\/\/www.hiv.gov\/hivbasics\/overview\/data-and-trends\/statistics [Last accessed: August8 2025]."},{"key":"e_1_3_6_4_2","unstructured":"Department of Health and Human Services. HIV Care Continuum. HIV.gov; 2025. Available from: https:\/\/www.hiv.gov\/federal-response\/other-topics\/hiv-aids-care-continuum [Last accessed: August8 2025]."},{"key":"e_1_3_6_5_2","unstructured":"Centers for Disease Control and Prevention. HIV Data. National HIV Prevention and Care Objectives. 2025. Available from: https:\/\/www.cdc.gov\/hiv-data\/nhss\/national-hiv-prevention-and-care-outcomes.html [Last accessed: August8 2025]."},{"key":"e_1_3_6_6_2","unstructured":"Centers for Disease Control and Prevention. Fast Facts: HIV and Transgender People. HIV.gov; 2025. Available from: https:\/\/www.cdc.gov\/hiv\/data-research\/facts-stats\/transgender-people.html [Last accessed: August8 2025]."},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00395-0"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-023-01992-6"},{"key":"e_1_3_6_9_2","unstructured":"Centers for Disease Control and Prevention. Fast Facts: HIV and Gay and Bisexual Men. HIV.gov; 2024. 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