Barriers to health care services for migrants living with HIV in Spain

Ndumbi, Patricia; Romero, Jorge del; Pulido, Federico; Arribas, María Velasco; Dronda, Fernando; Blanco, José Ramón; Olalla, Patricia García de; Ocaña, I; Belda-Ibáñez, Josefina; Amo, Julia del; Arco, Débora Álvarez-del

doi:10.1093/eurpub/ckx225

Cited by 28 publications

(19 citation statements)

References 28 publications

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“…Lack of proficiency in the host country's language among MLWH was the second most reported barrier impeding initial access to care and treatment at the individual level. 56 , 58 , 62 , 63 , 65 , 66 , 68 , 70 , 77 , 80 , 82 , 85 , 86 , 94 , 102 , 105 Language seemed to amplify navigation-related challenges in particular. 77 , 102 For example, physically navigating clinics and hospitals in North Carolina was made difficult due to lack of Spanish signage.…”

Section: Resultsmentioning

confidence: 99%

Barriers and Facilitators Affecting the HIV Care Cascade for Migrant People Living with HIV in Organization for Economic Co-Operation and Development Countries: A Systematic Mixed Studies Review

Arora

Ortiz-Paredes

Engler

et al. 2021

AIDS Patient Care and STDs

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Migrants in countries affiliated with the Organization for Economic Co-operation and Development (OECD) have a higher risk of acquiring HIV, experience delayed HIV diagnosis, and have variable levels of engagement with HIV care and treatment when compared to native-born populations. A systematic mixed studies review was conducted to generate a multilevel understanding of the barriers and facilitators affecting HIV Care Cascade steps for migrant people living with HIV (MLWH) in OECD countries. Medline, Embase, Scopus, CINAHL, and the Cochrane Library were searched on March 25, 2020. Screening, critical appraisal, and analysis were conducted independently by two authors. We used qualitative content analysis and the five-level Socio-Ecological Model (i.e., individual, interpersonal, organizational, community, and policy) to categorize barriers and facilitators. Fifty-nine studies from 17 OECD countries were included. MLWH faced similar barriers and facilitators regardless of their host country, ethnic and geographic origins, or legal status. Most barriers and facilitators were associated with the individual and organizational levels and centered around retention in HIV care and treatment. Adapting clinical environments to better address MLWH's competing needs via multidisciplinary models would address retention issues across OECD countries.

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Section: Resultsmentioning

confidence: 99%

Barriers and Facilitators Affecting the HIV Care Cascade for Migrant People Living with HIV in Organization for Economic Co-Operation and Development Countries: A Systematic Mixed Studies Review

Arora

Ortiz-Paredes

Engler

et al. 2021

AIDS Patient Care and STDs

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“…These barriers are not specific to HIV-related healthcare services and have been described widely in other studies regarding access to healthcare among migrants [13]. Although almost all participants were registered at a GP and migrants living with HIV in the Netherlands experience less difficulties accessing healthcare than migrants in some other countries in Europe [9, 14], these structural barriers in the access to care for migrants need to be addressed. In the Netherlands, all residents (including asylum seekers and refugees) are entitled to a basic health insurance package which includes the bulk of essential healthcare (including care provided by a GP), medications and medical aids [15].…”

Section: Discussionmentioning

confidence: 99%

Disparities in access to and use of HIV-related health services in the Netherlands by migrant status and sexual orientation: a cross-sectional study among people recently diagnosed with HIV infection

et al. 2019

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BackgroundMigrants often face barriers to accessing healthcare. We examined disparities in access to and use of HIV-related health services between migrant and non-migrant people recently diagnosed with HIV living in the Netherlands, taken into account sexual orientation. Also, we examined differences in experiences in living with HIV between these groups.MethodsWe used a questionnaire and clinical data collected between July 2013 and June 2015 among migrant and non-migrant participants of the European cross-sectional aMASE (Advancing Migrant Access to health Services in Europe) study in the Netherlands. Using univariable logistic regression analyses, we compared outcomes on between migrants and non-migrants, stratified by sexual orientation (with non-migrant men having sex with men [MSM] as the reference group).ResultsWe included 77 migrant MSM, 115 non-migrant MSM, 21 migrant heterosexual men, 14 non-migrant heterosexual men and 20 migrant women. In univariable analyses, all heterosexual groups were less likely to ever have had an HIV-negative test before their diagnosis and were more likely to be diagnosed late than non-migrant MSM. All migrant groups were more likely to have experienced difficulties accessing general healthcare in the Netherlands and were less likely to have heard of post-exposure prophylaxis than non-migrant MSM. Migrants frequently reported uncertainty about their rights to healthcare and language barriers. Most (93%) participants visited a healthcare facility in the 2 years before HIV diagnosis but only in 41% an HIV test was discussed during that visit (no statistical difference between groups). Migrant heterosexuals were more likely to have missed appointments at their HIV clinic due to the travel costs than non-migrant MSM. Migrant MSM and women were more likely to have experienced HIV discrimination in the Netherlands than non-migrant MSM.ConclusionDisparities in access to and use of HIV-related health services and experiences exist by migrant status but also by sexual orientation. Our data suggests heterosexual men and women may particularly benefit from improved access to HIV testing (e.g., through provider-initiated testing), while migrant MSM may benefit from improved access to HIV prevention interventions (e.g., pre-exposure prophylaxis).

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“…For instance, results from two qualitative studies ( 33 , 34 ) carried out in Catalonia about the needs and perceptions of healthcare providers on the provision of healthcare to migrants, suggested that communication barriers and low levels of cultural competency among professionals were the largest contributors to poor outcomes. Similarly, in a separate study of health-access barriers facing migrants with HIV ( 35 ), researchers found communication barriers were the main obstacle facing migrants of non-Spanish speaking countries.…”

Section: Discussionmentioning

confidence: 96%

“…These barriers could lead to delays in diagnosing and treating different diseases that carry not only individual, but important public health consequences such as tuberculosis, HIV, hypertension, diabetes, hepatitis B and C, schistosomiasis, strongyloidiasis, and Chagas ( 36 ). For example, in the previously mentioned study of migrants with HIV ( 35 ), 14–25% of migrants who reported barriers to healthcare access had been diagnosed with late HIV. Furthermore, increasing migrant engagement with preventive health initiatives such as vaccination and/or LTBI screening campaigns may confer benefits on them and the community ( 5 , 37 – 39 ).…”

Section: Discussionmentioning

confidence: 99%

A Cross-Sectional Survey on Professionals to Assess Health Needs of Newly Arrived Migrants in Spain

Serre-Delcor

Oliveira

Moreno

et al. 2021

Front. Public Health

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Heightened conflicts and lack of safety due to reasons related to economic, social, ethnic, religious, sexual orientation, political, or nationality matters have increased migratory movements during the last, few decades. Unfortunately, when migrants arrive in new territories, they can face many barriers. For example, in Spain, some migrants have difficulties in accessing health services. The main objective of this study was to describe, from the perspective of social and healthcare professionals, health needs and barriers faced among migrants who recently arrived in Spain when accessing the health system. To accomplish this aim, we carried out a cross-sectional descriptive study using a newly created self-administered questionnaire. Statistical analysis was done using the SPSS 23.00® program. Survey collection was from April 2018 to October 2018, and the cohort comprised a total of 228 professionals. Most participants were females (76%), with an average age of 35 years [interquartile range (IQR) 29.8–43.0]. The most represented profession in the cohort was physician (48%), followed by social care professionals (32%), nursing (11%), and other (8%). Of these individuals, 61% stated having either little or limited knowledge of international migrant health rights, and 94% believed migrants must overcome barriers to receive health services. The four most reported barriers were as follows: language, cultural differences, administrative issues, and fear of being undocumented. Additionally, by order of importance, professionals viewed mental health disorders and infectious diseases as the most common contributors to disease burden in this group. The four most popular strategies implemented by professionals to improve healthcare access further for migrants included intercultural competency training for professionals; access to community health agents; access to translators; and development of health system navigation skills among those newly arrived. Study results suggest that governments should make greater efforts to provide social and healthcare professionals with more effective tools that overcome communication barriers and cultural competence training modules.

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Barriers to health care services for migrants living with HIV in Spain

Abstract: Health care barriers were present in one in five5 MLWH, were more common in men and were associated to legal entitlement to access care, perceived stigma and financial constraints.

Cited by 28 publications

References 28 publications

Barriers and Facilitators Affecting the HIV Care Cascade for Migrant People Living with HIV in Organization for Economic Co-Operation and Development Countries: A Systematic Mixed Studies Review

Barriers and Facilitators Affecting the HIV Care Cascade for Migrant People Living with HIV in Organization for Economic Co-Operation and Development Countries: A Systematic Mixed Studies Review

Disparities in access to and use of HIV-related health services in the Netherlands by migrant status and sexual orientation: a cross-sectional study among people recently diagnosed with HIV infection

A Cross-Sectional Survey on Professionals to Assess Health Needs of Newly Arrived Migrants in Spain

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