The purpose of this research study was to develop a theoretical framework to explain the psychosocial process of care initiation in individuals living with HIV, and to identify the critical junctures that influence individuals living with HIV in their decision to initiate HIV care. Grounded theory method was used to identify the psychosocial process of care initiation by individuals living with HIV. Thirty individuals living with HIV (28 men, 2 women) shared their stories about initiating HIV care. Participants described a process in which they progressed through five distinct stages following diagnosis: a) receiving the news, b) interpreting the news, c) incorporating the news, d) acting on the news, and e) moving beyond the news. Each stage was moderated by influential factors including perceived susceptibility to HIV infection, symptoms, HIV information, and feedback from others. The participants were able to translate the news, from something bad into something good, as demonstrated in the constructed framework: “Translating the News: A Grounded Theory of HIV Care Initiation” A key to successful care initiation is helping individuals with HIV to realize that while the diagnosis may seem like bad news, there is also good news: HIV is not a death sentence


Grounded Theory, HIV, Care Initiation, HIV Treatment, HIV Care, HIV CareInitiation

Author Bio(s)

Joseph Perazzo is a postdoctoral fellow at Case Western Reserve University in the Frances Payne Bolton School of Nursing. He received his Bachelor of Science and Master of Nursing from Xavier University, Cincinnati OH, and his PhD in Nursing from the University of Cincinnati, Cincinnati, OH. Dr. Perazzo’s research interests center on the initiation of care by people living with HIV, and the impact of the care initiation/intake process on long-term treatment success and self-management practices, particularly among individuals with low health literacy. Correspondence regarding this article can be addressed directly to: Joseph Perazzo at josephdperazzo@gmail.com.

Donna Martsolf is a Professor and Associate Dean for Research and Translation at the University of Cincinnati, College of Nursing, Cincinnati, OH. Dr. Martsolf has spent nearly 3 decades conducting funded research studies examining interpersonal violence, its effects on health, and processes of healing. She has used a variety of qualitative research methodologies including, grounded theory, extensively in her research studies. Correspondence regarding this article can also be addressed directly to: Donna Martsolf at martsoda@ucmail.uc.edu.

Dr. Tracy Pritchard is Director of the Center for Educational Research, Scholarship and Innovations and Research Associate to the Institute for Nursing Research and Scholarship at the University of Cincinnati College of Nursing. She received her PhD in Systems Biology and Physiology from the University of Cincinnati, Cincinnati, OH. Dr. Pritchard’s research interests are access to education for underrepresented and disadvantaged students, process of transitioning to college for first-time students and molecular mechanisms of cardiovascular diseases. Correspondence regarding this article can also be addressed directly to: Tracy Pritchard at, pritchty@ucmail.uc.edu.

Rebecca Tehan is a program coordinator at the University of Cincinnati in the College of Nursing’s Institute for Nursing Research and Scholarship. She received her Bachelor of Arts from Miami University, Oxford, OH. Her background and current interests focus on socio-economic determinants of health affecting vulnerable populations. Correspondence regarding this article can also be addressed directly to: Rebecca Tehan at tehanra@ucmail.uc.edu.

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