title: A qualitative analysis of barriers to accessing HIV/AIDS-related services among newly diagnosed HIV-positive men who have sex with men in China.
abstract: In China, specific HIV/AIDS-related services have been in place since 2004. However, utilisation of these services remains limited among people living with HIV. We explored barriers to accessing HIV/AIDS-related services from the perspective of newly diagnosed HIV-positive men who have sex with men. We conducted repeated in-depth interviews with 31 newly diagnosed HIV-positive men who have sex with men, using the socio-ecological framework and thematic content analysis. Multiple barriers for utilisation of HIV/AIDS-related services were identified, including perceptions of subjective health and poor quality of services, mental and emotional health problems, lack of trust and understanding of the services on offer, low economic status, lack of insurance, and high medical fees, being refused access to services, and restrictive attendance policies. The findings provide information on potential multi-level obstacles preventing newly diagnosed HIV-positive men who have sex with men to use services that they need. It is recommended that policy makers should create a trustful and non-discriminating environment and services integrating physical and mental healthcare.
authors.affiliation: Pediatric Prevention Research Center, Wayne State University, Detroit, MI, USA jlau@cuhk.edu.hk.
authors.forename: Haochu Howard
authors.initials: HH
authors.lastname: Li
authors.affiliation: School of Health Sciences, RMIT University, Australia and Centre for Women's Health, Gender & Society, the University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Holroyd
authors.affiliation: Pediatric Prevention Research Center, Wayne State University, Detroit, MI, USA.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Li
authors.affiliation: Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Joseph
authors.initials: J
authors.lastname: Lau
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002681:China; D017144:Focus Groups; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D011287:Prejudice; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012944:Social Support; D055815:Young Adult
keywords: China; HIV/AIDS; MSM; barriers to access; men who have sex with men; newly diagnosed; qualitative; service utilisation; stigma