A Thematic Analysis of Resilient Experiences of People Who Inject Drugs Living with HIV Remaining in HIV Care

HIV disproportionately affects US Latinos as they account for 30% of all new HIV infections. A subpopulation also disproportionately affected are people who inject drugs (PWID) which account for 1 in 10 HIV diagnoses in the USA. PWID progression through the HIV treatment cascade is inhibited by various barriers. The barriers that PWID experience entering and remaining in HIV care have been documented extensively at the expense of research conducted to understand facilitators. The purpose of this study was to understand the experiences of PWID living with HIV (PWIDLH) in seeking medical treatment and the factors that facilitated remaining in HIV medical care.

We employed a resilience framework to analyze the data and interpret findings. The study site was the USA-Mexico border, a region characterized by a confluence of factors that promote forward HIV transmission such as population mixing, violence, sex work, and injection drug use. Participants were 20 PWIDLH (74% male) with a mean age of 43.5 years residing on the USA-Mexico border in the sister cities of Ciudad Juarez, Mexico, and El Paso, TX.

Results revealed three themes: resilience as a system of support, resilience as individual-level psychological resources and behavioral skills, and resilience as a transformative process that enables reciprocal determinism.

The study findings contribute to the understanding of the role of resilience among Latino PWIDLH residing in a medically underserved setting. Findings have implications for the development of interventions to promote resilience and motivate Latino PWIDLH to enter the HIV treatment cascade sooner and make successful progression.