Barriers to HIV care: an exploration of the complexities that influence engagement in and utilization of treatment.
This study is an exploration of engagement in outpatient medical care, medication utilization, and barriers to treatment utilization among 24 predominantly low-income, ethnic minority adults who were admitted to an urban hospital for HIV-related illnesses. A semi-structured interview was administered during the sample's hospital stay to explore patterns of service use and identify barriers to care. The majority of the sample was connected to an outpatient provider and satisfied with the care they received; however, most missed treatment appointments and skipped medication dosages. Health and treatment-related barriers, competing demands, and co-occurring mental health symptoms and illicit substance use were identified as barriers to care. Multiple obstacles indigenous to the individual, their treatment, and the environment prevented consistent treatment use among an economically disadvantaged ethnic minority sample: Implications and future directions in engaging vulnerable populations into health care for HIV are discussed.
New York State Psychiatric Institute, 100 Haven Avenue #31D, New York, NY 10032, USA. cavaleri@pi.cpmc.columbia.edu
Mary A
MA
Cavaleri
Kosta
K
Kalogerogiannis
Mary M
MM
McKay
Laura
L
Vitale
Erika
E
Levi
Sian
S
Jones
Fran
F
Wallach
Erin
E
Flynn
D000328:Adult; D001741:Black or African American / Q000523:psychology; D000553:Ambulatory Care / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000523:psychology* / Q000628:therapy*; D015438:Health Behavior / Q000208:ethnology; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D010349:Patient Compliance / Q000208:ethnology / Q000523:psychology*; D011203:Poverty; D019966:Substance-Related Disorders / Q000453:epidemiology; D014505:Urban Population