{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:25:20Z","timestamp":1790007920211,"version":"4.0.1"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T00:00:00Z","timestamp":1655856000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["6U01PS0051960100"],"award-info":[{"award-number":["6U01PS0051960100"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Aims<\/jats:title>\n<jats:p>To evaluate provider perspectives on the use of a point-of-care nucleic acid test (POC NAT) and preferential opinions for motivational interviewing (MI) or problem-solving counseling (PSC) as an ultra-brief intervention for patients experiencing challenges to antiretroviral therapy (ART) adherence.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A qualitative study was conducted among providers at an HIV care clinic in Seattle, Washington. Ten in-depth interviews with HIV care providers were completed, which explored determinants of acceptability, feasibility and preferences for a combined adherence counseling and POC NAT intervention for patients living with HIV. Interviews were analyzed through consensus coding and the Five A\u2019s Framework to inform thematic analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Providers favored the use of a combined adherence counseling technique and POC NAT for their non-adherent patients living with HIV. Providers believed the intervention was an improvement on current assessment and advising practices. However, concerns about extended wait times for the POC NAT results influenced perceptions about feasibility around clinic flow and incorporation into clinic practice. Providers believed that acceptability of POC NAT implementation would be enhanced by including a subset of patient populations whom tend to be in the clinic for longer periods, and in tandem face greater ART adherence challenges.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The GAIN Study will be the first project to evaluate the implementation of POC NAT in the U.S. Continued formative work is ongoing and may illustrate how best to address feasibility and concern around the two-hour time to result. The planned GAIN study will incorporate some of the findings found in this qualitative study and pilot this intervention, including a time-in-motion analyses of clinic flow, which may help reduce perceived wide-scale adaptation of POC NAT and ART adherence counselling among PLHW. Future work, including a shorter time to results and\/or lower limit detection could make a significant improvement in the provision of HIV care.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0270302","type":"journal-article","created":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T17:27:34Z","timestamp":1655918854000},"page":"e0270302","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Provider perspectives on the use of motivational interviewing and problem-solving counseling paired with the point-of-care nucleic acid test for HIV care"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7579-5480","authenticated-orcid":true,"given":"Dana L.","family":"Atkins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Violette","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Neimann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Tanner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Hoover","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepa","family":"Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8064-3011","authenticated-orcid":true,"given":"Joanne D.","family":"Stekler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,6,22]]},"reference":[{"issue":"1","key":"pone.0270302.ref001","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1086\/653445","article-title":"Long-Term Outcomes of HIV-Infected Patients with <95% Rates of Adherence to Nonnucleoside Reverse-Transcriptase Inhibitors","volume":"51","author":"A. 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Stekler","year":"2007","journal-title":"Ann Intern Med"},{"issue":"3","key":"pone.0270302.ref017","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1086\/600043","article-title":"HIV testing in a high-incidence population: Is antibody testing alone good enough?","volume":"49","author":"JD Stekler","year":"2009","journal-title":"Clin Infect Dis"},{"issue":"2","key":"pone.0270302.ref018","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/S0166-0934(02)00102-7","article-title":"Comparative evaluation of eight commercial enzyme linked immunosorbent assays and 14 simple assays for detection of antibodies to HIV","volume":"105","author":"G Beelaert","year":"2002","journal-title":"J Virol Methods"},{"issue":"8","key":"pone.0270302.ref019","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1089\/aid.2017.0276","article-title":"No Time to Delay! Fiebig Stages and Referral in Acute HIV infection: Seattle Primary Infection Program Experience","volume":"34","author":"JD Stekler","year":"2018","journal-title":"AIDS Res Hum Retroviruses"},{"issue":"2","key":"pone.0270302.ref020","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1207\/S15324796ABM2402_04","article-title":"Self-management aspects of the improving chronic illness care breakthrough series: Implementation with diabetes and heart failure teams","volume":"24","author":"RE Glasgow","year":"2002","journal-title":"Ann Behav Med"},{"key":"pone.0270302.ref021","article-title":"The transtheoretical model of health behavior change","author":"JO Prochaska","year":"1997","journal-title":"Am J Heal Promot"},{"key":"pone.0270302.ref022","first-page":"1","article-title":"Treating tobacco use and dependence: 2008 update","author":"SF Dorfman","year":"2011","journal-title":"Clin Treat Guid Tob Use Depend"},{"issue":"1","key":"pone.0270302.ref023","first-page":"27","article-title":"Clinical review: modified 5 As: minimal intervention for obesity counseling in primary care","volume":"59","author":"M Vallis","year":"2013","journal-title":"Can Fam Physician"},{"issue":"12","key":"pone.0270302.ref024","first-page":"1449","article-title":"Office-based strategies for the management of obesity","volume":"81","author":"G. Rao","year":"2010","journal-title":"Am Fam Physician"},{"issue":"7","key":"pone.0270302.ref025","first-page":"504","article-title":"The 5 As framework for obesity management: Do we need a more intricate model?","volume":"63","author":"E Sturgiss","year":"2017","journal-title":"Can Fam Physician"},{"issue":"9","key":"pone.0270302.ref026","doi-asserted-by":"crossref","first-page":"3377","DOI":"10.1128\/JCM.00593-14","article-title":"SAMBA HIV semiquantitative test, a new point-of-care viral-load-monitoring assay for resource-limited settings","volume":"52","author":"A V. Ritchie","year":"2014","journal-title":"J Clin Microbiol"},{"issue":"5","key":"pone.0270302.ref027","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1001\/jama.2018.21167","article-title":"HIV Viral Load and Transmissibility of HIV Infection Undectable Equals Untransmittable","volume":"321","author":"R.W. Eisinger","year":"2019","journal-title":"Jama"},{"issue":"1","key":"pone.0270302.ref028","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.pec.2014.10.007","article-title":"Training primary care clinicians in motivational interviewing: A comparison of two models","volume":"98","author":"SS Fu","year":"2015","journal-title":"Patient Educ Couns"},{"issue":"4","key":"pone.0270302.ref029","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1007\/s13142-011-0080-9","article-title":"Implementing motivational interviewing in primary care: The role of provider characteristics","volume":"1","author":"AM Midboe","year":"2011","journal-title":"Transl Behav Med"},{"issue":"4","key":"pone.0270302.ref030","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1037\/fsh0000145","article-title":"Challenges in Developing Primary Care Physicians\u2019 Motivational Interviewing Skills","volume":"33","author":"Daniel J. 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