AEGiS-14IAC: Strategies for increasing access and utilization of HIV care among US minorities.

14th International AIDS Conference


Barcelona, Spain - July 7-12, 2002

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Strategies for increasing access and utilization of HIV care among US minorities.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. G12518)

Richards TA, Vernon K, Morin SF
UCSF Center for AIDS Prevention Studies, San Francisco, United States

ISSUES: In light of a national goal to eliminate racial and ethnic disparities in HIV care, this study examined publicly insured African Americans and Latinos in the US.

DESCRIPTION: 8 HIV specialty clinics, 4 serving African Americans and 4 serving Latinos were selected in New York, California, Texas and Florida. Data were collected and analyzed through a rapid assessment ethnography using: 1) descriptive and epidemiological data; 2) ethnographic observations; 3) face-to-face semi-structured interviews with clinic patients and providers. Interviews were coded for barriers and facilitators to care.

ISSUES: Convergent themes in patient and provider interviews revealed the following. Barriers: 1) poverty making basic life needs a priority over HIV; 2) resistance to testing due to stigmatization, lack information and cultural pre-dispositions with HIV; 3) restriction of Medicaid eligibility for people with non-disabling HIV; 4) co-payments for HIV drugs obtained through ADAP; 5) inadequate support services. Facilitators: 1) outreach for testing via HIV treatment education; 2) immediate and personal mechanisms to help transition to care at the time a test result is given; 3) comprehensive medical and social support services centralized at the clinic; 4) culturally matched or sensitized providers demonstrating a strong commitment to the patient population; 5) assisting patients in establishing family or peer support networks.

RECOMMENDATIONS: Recommendations for policy: 1) development of neighborhood community health centers providing HIV care integrated with comprehensive medical and social services; 2) sustained outreach programs providing HIV treatment education; 3) elimination of restrictions on access to Medicaid and co-payments for ADAP pharmaceuticals; 4) recruitment and training of racial/ethnic specific HIV-specialty providers.

Keywords: AEGIS, HIV Infections, HIV Seropositivity, Ethnic Groups, African Americans, Medicaid, Hispanic Americans, Counseling, Thinking, Learning, Interviews, California, Florida, Texas, New York, Case-Control Studies, Greece, Human, utilization, economicsKWDaegis,hivinfections,hivseropositivity,ethnicgroups,africanamericans,medicaid,hispanicamericans,counseling,thinking,learning,interviews,california,florida,texas,newyork,case-controlstudies,greece,human,utilization,economics

020707
G12518

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.