266602 Facilitators and barriers to care initiation and continuity among persons living with HIV/AIDS in rural South Carolina: A qualitative study

Wednesday, October 31, 2012

Donna L. Richter, EdD, FAAHB , Department of Health Promotion, Education and Behavior, University of South Carolina-Arnold School of Public Health, Columbia, SC
Medha V. Vyavaharkar, PhD, MPH, MD , South Carolina Rural Health Research Center, Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina., Columbia, SC
Lucy Annang, PhD, MPH , Department of Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, Columbia, SC
Leah Williams, DrPH, MPH , Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
Saundra Glover, MBA, PhD , Institute for Partnerships to Eliminate Health Disparities, University of South Carolina - Arnold School of Public Health, Columbia, SC
Background: Established clinical guidelines and advances in antiretroviral therapies have significantly reduced morbidity and mortality among persons living with HIV/AIDS (PLWHA). Early initiation of care and continued engagement in care are vital for HIV treatment success at both the individual and population levels. However, a significant proportion of PLWHA fails to seek and remain in care after initial diagnosis. Identifying factors that influence patterns of utilization of HIV care among PLWHA is critical to developing strategies to increase initiation of and retention in care. This study identified personal, organizational, and environmental factors that facilitate or inhibit care initiation and care continuity among PLWHA living in a rural, predominantly minority county in South Carolina. Methods: The study employed focus group discussions with PLWHA and personal interviews with health care providers. Audio-recordings of the discussions and interviews were transcribed and analyzed to identify major themes. Results: Participating PLWHA identified several facilitators as well as multiple barriers to accessing and continuing care. Need for survival, self-determination, stigma, discrimination, disclosure, availability of infectious disease doctor, patient-provider interactions, transparency in provider actions and communication, and organizational culture/environment were some of the important themes that emerged from focus group discussions. Analysis of provider interviews yielded both similar and different themes, including the importance of a professional, trusting, and respectful care environment to facilitate access to care. Conclusion: Findings identify potential points of interventions to improve rates of initiation of and retention in care among PLWHA.

Learning Areas:
Public health or related research

Learning Objectives:
1) Identify facilitators to initiate and continue care among persons living with HIV/AIDS (PLWHA) 2) Identify barriers to initiate and continue care among PLWHA

Keywords: Access to Health Care, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI on this study and have been conducting HIV/AIDS related research for over more than two decades.
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.