207715 What drives patients to delay HIV care? Preliminary results from a cross-sectional study of a multiracial/ethnic population of HIV-positive persons in California who have never received HIV care

Monday, November 9, 2009

Mara. Luisa Ziga, PhD , Division of Global Public Health, University of California, San Diego, La Jolla, CA
Estela Blanco , Division of Global Public Health, University of California, San Diego, La Jolla, CA
Robin A. Pollini, PhD MPH , Division of Global Public Health, University of California, San Diego, La Jolla, CA
Karen Haye , Division of Global Public Health, University of California, San Diego, La Jolla, CA
Background: Communities of color are disproportionately represented among persons living with HIV who delay entry into HIV medical care. Understanding ethnic/racial differences in care initiation can inform targeted interventions to improve treatment entry.

Methods: HIV-infected patients who knew their status ≥ 3 months and had never received HIV care were recruited by outreach workers from 11 Bridge Project sites throughout California for an interview (English/Spanish) on their demographics, sexual behaviors, drug use and barriers to HIV care. Results represent data collected between 09/2006-01/2009.

Results: Sixty-five participants completed the survey with 71% male; 42% Latino, 28% Black, 23% White, and 6% other ethnicity/race; and a median age of 32 years (range 19-64 years). Reasons for not initiating HIV medical care included: "Didn't want to think about being HIV-positive" (72%); "Didn't want to tell anyone I was HIV positive" (57%); "Too embarrassed/ashamed to go" (39%); and "Believed that the HIV positive test was wrong (35%)". Latinos were significantly more likely than non-Latinos to report that they believe the HIV test result was wrong, HIV doesn't exist, and natural remedies are safer than HIV medications. Non-Latinos were significantly more likely than Latinos to cite drinking and/or using drugs and missing appointments as barriers to care.

Conclusions: Reasons for delaying HIV care differ by ethnicity/race. In this study, barriers for Latinos were related to patient denial about illness while non-Latinos were more likely to cite substance abuse and missed appointments. Our findings may inform culturally-tailored efforts to better link HIV testing and care.

Learning Objectives:
Describe reasons for delaying HIV care Describe potential ethnic and racial differences in reasons for delaying care Describe new avenues to reduce delays in care among populations at risk for delays

Keywords: HIV/AIDS, Health Care Utilization

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI of the study from UCSD.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Other HIV/AIDS Topic Areas
See more of: HIV/AIDS