title: Considering care-seeking behaviors reveals important differences among HIV-positive women not engaged in care: implications for intervention.
abstract: We sought to examine characteristics of HIV-positive women with varying levels of engagement in care and care-seeking behaviors. From 2010 to 2013, in a multi-site US-based study of engagement in care among HIV-positive women, we conducted baseline interviews, which included socio-demographic, clinical, and risk behavior characteristics, and barriers to care. We used multinomial logistic regression to compare differences among three distinct categories of 748 women: engaged in care; not engaged in care, but seeking care ("seekers"); and not engaged in care and not seeking care ("non-seekers"). Compared with women in care, seekers were more likely to be uninsured and to report fair or poor health status. In contrast, non-seekers were not only more likely to be uninsured, but, also, to report current high-risk drug use and sexual behaviors, and less likely to report transportation as a barrier to care. Examining care-seeking behaviors among HIV-positive women not engaged in care revealed important differences in high-risk behaviors. Because non-seekers represent a particularly vulnerable population of women who are not engaged in care, interventions targeting this population likely need to address drug use and be community-based given their limited interaction with the health care system.
authors.affiliation: 1 Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center , Bronx, New York.
authors.forename: Oni J
authors.initials: OJ
authors.lastname: Blackstock
authors.forename: Arthur E
authors.initials: AE
authors.lastname: Blank
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Fletcher
authors.forename: Niko
authors.initials: N
authors.lastname: Verdecias
authors.forename: Chinazo O
authors.initials: CO
authors.lastname: Cunningham
mesh_terms: D000328:Adult; D005260:Female; D006679:HIV Seropositivity / Q000208:ethnology* / Q000523:psychology* / Q000628:therapy; D015438:Health Behavior / Q000208:ethnology*; D006296:Health Services / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000523:psychology; D011159:Population Surveillance; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology