Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113013

Jo L. Sotheran, PhD, Research Consultant, 25 Plaza St. (#2-L), Brooklyn, NY 11217, (718) 398-4729, JSotheran@aol.com, Elizabeth Needham Waddell, PhD, Bureau of Maternal Infant and Reproductive Health, New York City Department of Health and Mental Hygienne, 2 Lafayette St., 18th Fl., New York, NY 10007, and Angela A. Aidala, PhD, Center for Applied Public Health, Columbia University, 722 West 168th Street, Suite 1119, New York, NY 10032.

BACKGROUND: Too many HIV-infected people lose the benefits of life-prolonging treatment because of delays: delaying treatment enrollment after positive HIV tests, or delaying testing until already symptomatic. A NYC HIV Health and Human Services Planning Council commissioned study attempted to identify contextual factors in delays. METHODS: We conducted 7 focus groups in 2002-2003, recruited from support groups at agencies serving populations suggested by prior research as at particular risk. Groups, predominantly people of color, included: MSMs, transgenders, drug users, drug injectors, homeless people, former correctional inmates, and low-income heterosexual women. Although recruited regardless of HIV status, many in each group were disclosed HIV+s. RESULTS: Across groups, similar factors conditioned delays in both testing and in post-testing treatment enrollment. Factors included: stigma of HIV, little understanding of monitoring or treating an asymptomatic condition, previous poor medical care experiences, fear of the unknown, and little knowledge of existing HIV treatment and services. Among groups, transgenders described the worst medical care experiences, MSM the best knowledge of treatment resources, former correctional inmates the greatest difficulty in transitioning from diagnosis to care. HIV+ participants praised the superior availability and quality of the HIV-specific treatment system relative to the general medical system, and cited lack of prior knowledge about available HIV treatment and support as barriers to their own testing and/or treatment. CONCLUSIONS: Improving general medical settings that provide entry to HIV testing and treatment, combating HIV-associated stigma, and increasing pre-diagnosis information on medical treatment and support services, could increase at-risk populations' access to treatment.

Learning Objectives:

(
• List the 2 stages at which delays to treatment evaluation for the HIV-infected may occur. (
• Identify 3 different barriers to testing and presentation for treatment enrollment that are common to representatives of the different at-risk populations considered. (
• Describe the role of realistic information about treatment in encouraging HIV testing and presentation for treatment enrollment.

Keywords: Access to Care, Underserved Populations

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.