title: Transportation vulnerability as a barrier to service utilization for HIV-positive individuals.
abstract: Research suggests that transportation vulnerability can negatively impact adherence to HIV-related medical treatment. Moreover, transportation can be a barrier to accessing ancillary services which can increase positive health outcomes for HIV-positive individuals. This study examines transportation vulnerability and its impact on HIV-related health and ancillary service utilization in the Mid-South Region. Focus groups and interviews were conducted with service providers and HIV-positive individuals, and survey data were collected from HIV-positive individuals (N=309) using the five A's of access to frame transportation vulnerability: availability, accessibility, accommodation, affordability, and acceptability. Study results indicate that transportation vulnerability can present significant barriers to service utilization for HIV-positive individuals, including insufficient transportation infrastructure, incompatible fit between transportation and health systems, and insensitivity to privacy issues. One consequence of transportation vulnerability is reliance upon weaving together multiple modes of transport to access care and ancillary services, creating additional barriers to service utilization and medical adherence. The research team recommends more investment in public transit systems, expanded services, and innovative approaches to solving procedural problems.
authors.affiliation: a Center for Research on Women , The University of Memphis , Memphis , TN , USA.
authors.forename: Lynda M
authors.initials: LM
authors.lastname: Sagrestano
authors.forename: Joy
authors.initials: J
authors.lastname: Clay
authors.forename: Ruthbeth
authors.initials: R
authors.lastname: Finerman
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gooch
authors.forename: Melanie
authors.initials: M
authors.lastname: Rapino
mesh_terms: D000328:Adult; D000368:Aged; D001131:Arkansas; D003153:Community Health Services / Q000191:economics / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000628:therapy*; D006297:Health Services Accessibility / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D008922:Mississippi; D009936:Organizational Innovation; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012944:Social Support; D013714:Tennessee; D014187:Transportation of Patients / Q000191:economics / Q000379:methods / Q000458:organization & administration*