Table 3.

De-adoption themes and supporting quotes

Theme	Number	Supporting quote
Agency realignment	3.1	I knew that in order to be the most competitive for another five years that we should move in that direction. Once again, so we were the most competitive, but also so that we’re gonna be successful if awarded, right? Because we want to show we have quality programming.
	3.2	It seemed like funding, the landscape, was absolutely shifting, and it seemed like our director’s proposal was a way to put us in a position so that we could receive funding in the future.
Disconnect among services	3.3	We got a lot of referrals from case managers who knew that their clients needed to have those conversations ….We have definitely had case managers still coming to us, asking, like “Okay, well what do I do with this person now?”
	3.4	Because our case managers are working to make sure that their housing’s table and they’re making their appointments…that they don’t really get that training on how to have these frank conversations. And some of them aren’t comfortable having those conversations.
Frustration and concern	3.5	It’s just a frustrating place to be. Because does it work for every single person? No….But on a personal lower-level when you’re working with individuals who tell you how much the intervention has meant to them and how it’s made them think different [or], how it’s just been nice to have somebody who cares and listens to them without judging them….It’s not necessarily a measurable impact.
	3.6	It doesn’t feel like it’s even a place that I belong anymore. And a lot of that was just a cultural shift. It’s disappointing. I think that I can do this work, and I continue to do work with people in helping them find resources and being a true navigator, but I don’t want to do it in that setting.
Client/community	3.7	We’ve had a lot of people continue to ask for RESPECT… So that sucks to tell people whether its clients or staff that like, “Sorry, we can’t help you. We don’t have money to do that anymore.”
	3.8	I think there’s always the consequence of damaging relationships of like offering some services [like RESPECT] and then pulling them out, and promoting X.
	3.9	For negative people they can still have those conversations as part of the HIV testing situation. But positive folks don’t have that. And so, if they’re not having those conversations with their doctor or their case manager, then they really [aren’t having the conversation]—it was a loss of that space.
	3.10	It removed completely those resources for folks who were in places where they were ready to have conversations about their risk to help reduce it. Now we’re just medicalizing, and I’m telling people to go onto [pre-exposure prophylaxis], and I don’t know that’s enough for folks.