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This article overviews a Health Resources and Services Administration (HRSA) study with a sample population consisting of 470 Hispanic/Latino persons living with HIV/AIDS who received primary HIV/AIDS medical services from one of five HRSA Special Projects of National Significance (SPNS) Border Health demonstration projects. The study purpose was to identify multilevel barriers that affect delayed entry into HIV/AIDS medical care among Hispanic/Latino persons living along the U.S.-Mexico border. Multilevel variables along individual, community/cultural, and structural/systems were assessed relative to delayed care entry. The results of this examination indicate that individual and structural/system-level variables affect delayed care entry, whereas support was not found for community/cultural-level barriers. Study findings inform treatment engagement strategies aimed to decrease HIV disease progression by bringing Hispanic/Latinos into care sooner.

There is high demand for care among the Hispanic population in states along the U.S.-Mexico border. The objective is to describe the standard of care received by people living with HIV/AIDS (PLWH/A) at enrollment into one of five Special Projects of National Significance (SPNS) Sites located along the U.S.-Mexico border. This cross-sectional study describes the presence of opportunistic infections (OIs), AIDS status and two types of standard of care received by 707 PLWH/A participating in SPNS. Patients receiving care through SPNS in one of the five sites between June 1, 2002 and December 31, 2003 were invited to participate to the medical chart review component of the study. The association between sociodemographic variables and the prevalence of OIs and AIDS at enrollment was estimated using multivariate hierarchical logistic models. More than one quarter of the 707 participants had at least one OI recorded and 58% of new and 60% of existing patients had AIDS at enrollment in SPNS. The association between being Hispanic and having higher prevalence of OI and AIDS at entry varied by SPNS site. Standard of care was well followed overall. This is the first study describing HIV stage and OI prevalences and standard of care in PLWH/A in all U.S.-Mexico bordering states. Being of Hispanic ethnicity may not fully explain discrepancy in access to care along the border.

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