Rural HIV-positive African American women's perceptions of their health care experiences

This qualitative study explored the perceptions of HIV-positive rural African American women's health care experiences. Twenty-two women residing in rural areas of South Carolina were recruited to participate in one of three focus groups. A conceptual model of health services utilization was used to guide the study and served as a framework for coding data. Verbatim transcripts of group discussions were analyzed using content analysis to code and identify data categories. The major themes that emerged were: 1) unsatisfactory medical services including mental health care; 2) poor attitudes and behaviors of caregivers; 3) lack of patient-provider communication; and 4) lack of coordination and collaboration between different providers. The findings provide evidence of the difficulties Rural African American women with HIV disease have in accessing and utilizing available services because of the quality of services and treatment by providers. The women's experiences were infused with feelings of frustration, anger, and hopelessness because of the confusing, unpredictable, and uncaring nature of existing health care systems. Overall, findings provide a picture of women falling through the cracks of the health care system. The findings have significant implications for increasing resources and designing interventions that empower these women and enhance their quality of life.