Date of Conferral





Human Services


Mary E. Bold


Previous research on HIV medical adherence has focused on incentive-based interventions, while previous research with the chronically homeless has focused on substance abuse, mental illness, and health disparities. This qualitative study focused on the experiences and perceptions of medical providers in a metropolitan area who work on medical adherence with homeless people living with HIV and mental illness. Ecological systems theory provided foundation to explore how medical providers form interventions based on clients’ ecosystems. The data were collected via audio-recorded, semi-structured interviews with 15 case managers, mental health therapists, nurses, and primary care physicians who worked at outpatient medical centers. Data were transcribed using the Temi software and coded using Microsoft Excel. Data were analyzed by using Verbal Exchange Coding. Two themes emerged: interdependence and interpretations. Interdependence included the need for services, interpretation was based on the providers understanding of the need for client support. Participants saw the need for transportation as a barrier for homeless clients to keep medical appointments. They also saw the necessity for housing as a barrier for medication adherence and medication security due to stigmas. This study might benefit students completing college who plan to work in community healthcare clinics and with medical providers’ continuing education endeavors. The study highlights the need for further education of medical providers within the context of the social policy and harm reduction model called Housing First.