Barriers to access to care reported by women living with HIV across 27 countries

Abstract

Increased access to successful antiretroviral therapy (ART) is necessary in order to achieve an AIDS-free generation. Importantly, slightly over half of the people living with HIV are women. Small studies have described many barriers to accessing treatment and care among women living with HIV. This cross-sectional, non-interventional, epidemiological study assessed the prevalence of barriers to accessing care for women living with HIV across 27 countries, divided into four global regions. HIV-positive women attending routine clinical visits were offered the opportunity to participate in the study. Data describing the study sites and demographic characteristics of the participating women were collected. Participating women filled out questionnaires including the Barriers to Care Scale (BACS) questionnaire, on which they reported the extent to which they found each of the 12 potential barriers to accessing health care problematic. A total of 1931 women living with HIV were included in the study: 760 from Western Europe and Canada (WEC), 532 from Central and Eastern Europe (CEE), 519 from Latin America (LA), and 120 from China. The mean age of participating women was 40.1 ± 11.4 years. A total of 88.2% were currently taking ART. A total of 81.8% obtained HIV treatment under a government health plan. The most prevalent barrier to care was community HIV/AIDS stigma. Community HIV/AIDS knowledge, lack of supportive/understanding work environments, lack of employment opportunities, and personal financial resources were also highly prevalent barriers to accessing care. These findings indicate that, more than 30 years after the start of the AIDS epidemic, stigma is still a major issue for women living with HIV. Continued efforts are needed to improve community education on HIV/AIDS in order to maximize access to health care among women living with HIV.

Attitude of Health Care Workers (HCWs) toward Patients Affected by HIV/AIDS and Drug Users: A Cross-Sectional Study

“…As observed in other studies, the positive attitudes of HCWs have been correlated with high levels of HIV/AIDS and alcohol consumption knowledge [5,10,11,12,13,19], and also through on-going training [8]. …”

“…Those able to access medical care are living longer and have improved their health thanks to antiretroviral medications. These patients are experiencing acute HIV-related chronic episodes and other types of illness that can require hospitalization and/or supportive care arrangements [4,5]. Several studies have investigated the attitudes, knowledge and practices of health care workers (HCWs) towards patients with HIV/AIDS and underlined that HCWs still fear the disease and behave prejudicially toward HIV/AIDS patients [6,7,8,9,10,11].…”

The Influence of Neurocognitive Impairment, Depression, and Alcohol Use Disorders on Health-Related Quality of Life among Incarcerated, HIV-Infected, Opioid Dependent Malaysian Men: A Moderated Mediation Analysis

“…With the recent advances in prophylactic and therapeutic strategies, the transformation of HIV into a chronic medical condition where PLWH can be expected to have a normal life expectancy if receiving recommended treatment [3] has resulted in their health-related quality of life (HRQoL) emerging as a key focus for researchers and healthcare providers [4]. As with any other chronic illness, PLWH face numerous personal, social, mental, and physical comorbidities that can affect their HRQoL [5, 6]. The complex interplay between HIV and these comorbidities has generated an urgency to maximize the HRQoL experienced by PLWH [7].…”

Development of internalized and personal stigma among patients with and without HIV infection and occupational stigma among health care providers in Southern China

“…Studies have shown that HIV/AIDS stigma is a barrier for PLWHA-seeking health care due to lack of community HIV/AIDS knowledge, lack of understanding supportive clinic environments, absence of personal financial resources,3 and lack of employment opportunities 4. Although attention to stigma has steadily increased, it is especially important to comprehensively understand HIV/AIDS stigma under a measurable conceptual framework from different individuals’ perspectives in order to improve access to HIV health care.…”