Perceived Barriers to HIV Care Among HIV-Infected Women in the Deep South

Self Cite

African American women have disproportionately high prevalence rates of HIV and cervical cancer. HIVinfected women are significantly less likely to obtain recommended cervical cancer screenings than HIVuninfected women. The purpose of this study was to examine sociocultural and structural factors associated with cervical cancer screening among HIV-infected African American in Alabama. The PEN-3 Model and the Health Belief Model were used as theoretical frameworks. In-depth interviews were conducted with twenty HIV-infected African American women to identify perceptions, enablers, and nurturers, perceived susceptibility, perceived severity, and perceived benefits related to cervical cancer and screening. The most common positive perceptions, enablers, and nurturers that contributed to cervical cancer screening included internal motivation and awareness of the importance of HIV-infected women getting Pap tests due to their weakened immune system. Negative perceptions, enablers, and nurturers included lack of knowledge about cervical cancer and screening, and lack of perceived susceptibility to cervical cancer. The results of this study can be used to guide the development of culturally relevant cervical cancer and screening education interventions aimed at increasing cervical cancer screening adherence among HIV-infected African American women.

Section: (Age 48 No Pap Test)mentioning

confidence: 94%

Structural and Sociocultural Factors Associated with Cervical Cancer Screening Among HIV-Infected African American Women in Alabama

Williams

Moneyham

Kempf

et al. 2015

Self Cite

“…In addition, participants acknowledged well-documented barriers to keeping appointments, such as substance use, lack of transportation, loss of private health insurance, and family caregiving responsibilities. 25 However, an important theme that emerged was that participants did not make conscious decisions to stop coming to appointments. Rather, they simply had competing priorities, or, at times, no stated reason.…”

Section: Out-of-care Experiencementioning

confidence: 99%

“Taking a Half Day at a Time:” Patient Perspectives and the HIV Engagement in Care Continuum

Christopoulos

Massey

López

et al. 2013

The HIV treatment continuum, or ''cascade,'' outlines key benchmarks in the successful treatment of HIV-infected individuals. However, the cascade fails to capture important dimensions of the patient experience in that it has been constructed from a provider point of view. In order to understand meaningful steps in the HIV care cascade for individuals diagnosed with HIV through expanded, more routine testing, we conducted in-depth interviews (n = 34) with three groups of individuals: those diagnosed with HIV in the emergency department/urgent care clinic who linked to HIV care and exhibited 100% appointment adherence in the first 6 months of HIV care; those diagnosed in the emergency department/urgent care clinic who linked to HIV care and exhibited sporadic appointment adherence in the first 6 months of HIV care, and; hospitalized patients with no outpatient HIV care for at least 6 months. This last group was chosen to supplement data from in-care patients. The engagement in care process was defined by a changing perspective on HIV, one's HIV identity, and the role of health care. The linkage to care experience laid the groundwork for subsequent retention. Interventions to support engagement in care should acknowledge that patient concerns change over time and focus on promoting shifts in perspective.

“…Minority women continue to report difficulties entering and staying in care. [1][2][3][4][5] Women report being disconnected from medical care providers, and while experiencing competent and caring providers, women report they do not have sufficient information to live safely with HIV. [6][7][8] The epidemiology of HIV/AIDS in the United States reflects a shift towards people of color and the poor.…”

Section: Introductionmentioning

confidence: 99%

Baseline Social Characteristics and Barriers to Care from a Special Projects of National Significance Women of Color with HIV Study: A Comparison of Urban and Rural Women and Barriers to HIV Care

Eastwood

Fletcher

Quinlivan

et al. 2015

We describe the baseline sociodemographic characteristics of the Health Resources and Services Administration's Special Programs of National Significance Women of Color (WOC) Initiative. Between November 2010 and July 2013, 921 WOC were prospectively enrolled in HIV medical care at nine sites, six urban (N = 641) and three rural sites (N = 280) across the US. We describe the study sample, drawing comparisons between urban and rural sites on sociodemographics, barriers to HIV care, HIV care status at study entry, substance use and sexual risk factors, and the relationship among these variables. Urban sites' participants differed from rural sites on all sociodemographic variables except age (median = 42.3). Women at urban sites were more likely to be Hispanic, less educated, single, living alone, unstably housed, unemployed, and to have reported lower income. More urban women were transferring care to HIV care or had been lost to care. Urban women reported more barriers to care, many relating to stigma or fatalism about HIV care. Urban women reported more substance use and sexual risk behaviors. A better understanding of how HIV care is embedded in communities or fragmented across many sites in urban areas may help understand barriers to long-term engagement in HIV care encountered by WOC.