title: System and Patient Barriers to Care among People Living with HIV/AIDS in Houston/Harris County, Texas: HIV Medical Care Providers' Perspectives.
abstract: In the United States, a considerable number of people diagnosed with HIV are not receiving HIV medical care due to some barriers. Using data from the Medical Monitoring Project survey of HIV medical care providers in Houston/Harris County, Texas, we assessed the HIV medical care providers' perspectives of the system and patient barriers to HIV care experienced by people living with HIV/AIDS (PLWHA). The study findings indicate that of the 14 HIV care barriers identified, only 1 system barrier and 7 patient barriers were considered of significant (P ≤ .05) importance, with the proportion of HIV medical care providers' agreement to these barriers ranging from 73.9% (cost of health care) to 100% (lack of social support systems and drug abuse problems). Providers' perception of important system and patient barriers varied significantly (P ≤ .05) by profession, race/ethnicity, and years of experience in HIV care. To improve access to and for consistent engagement in HIV care, effective intervention programs are needed to address the barriers identified especially in the context of the new health care delivery system.
authors.affiliation: Houston Department of Health and Human Services, Office of Surveillance and Public Health Preparedness, Houston, TX, USA osaro.mgbere@houstontx.gov.
authors.forename: Osaro
authors.initials: O
authors.lastname: Mgbere
authors.affiliation: Houston Department of Health and Human Services, Office of Surveillance and Public Health Preparedness, Houston, TX, USA.
authors.forename: Salma
authors.initials: S
authors.lastname: Khuwaja
authors.affiliation: Department of Internal Medicine, UTHEALTH Medical School, University of Texas Health Science Center, Houston, TX, USA.
authors.forename: Tanvir K
authors.initials: TK
authors.lastname: Bell
authors.affiliation: Infectious Diseases Section, Michael E. DeBakey VA Medical Center, Houston, TX, USA Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Rodriguez-Barradas
authors.affiliation: Houston Department of Health and Human Services, Office of Surveillance and Public Health Preparedness, Houston, TX, USA.
authors.forename: Raouf
authors.initials: R
authors.lastname: Arafat
authors.affiliation: Institute of Community Health, University of Houston College of Pharmacy, Texas Medical Center, Houston, TX, USA.
authors.forename: Ekere James
authors.initials: EJ
authors.lastname: Essien
authors.affiliation: Houston Department of Health and Human Services, Office of Surveillance and Public Health Preparedness, Houston, TX, USA.
authors.forename: Mamta
authors.initials: M
authors.lastname: Singh
authors.affiliation: Houston Department of Health and Human Services, Office of Surveillance and Public Health Preparedness, Houston, TX, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Aguilar
authors.affiliation: Houston Medical Monitoring Project Community Advisory Board, Houston, TX, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Roland
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology; D000328:Adult; D003376:Counseling; D003695:Delivery of Health Care; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010465:Perception; D057545:Social Stigma; D013781:Texas; D014504:Urban Health
keywords: HIV medical care provider; HIV/AIDS; Houston/Harris County; Texas; patient barrier; system barrier