title: 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.
abstract: 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.
authors.affiliation: 1 Brooklyn College and CUNY School of Public Health, City University of New York , New York City, New York.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Eastwood
authors.forename: Jason
authors.initials: J
authors.lastname: Fletcher
authors.forename: E Byrd
authors.initials: EB
authors.lastname: Quinlivan
authors.forename: Niko
authors.initials: N
authors.lastname: Verdecias
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Birnbaum
authors.forename: Arthur E
authors.initials: AE
authors.lastname: Blank
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012309:Risk-Taking; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D019037:Urban Health Services / Q000458:organization & administration*; D014505:Urban Population