Correlates of health concerns and barriers to receiving HIV care among women of color at risk of falling out of care

Background and Methods: HIV+ women who are new to care, returning, or at risk of falling out of care have been enrolled prospectively in medical care at several sites in Brooklyn using a peer outreach worker-case manager pairing since November, 2010 as part of a larger national demonstration to retain women of color in care. This study reports on the first year's participants from the Brooklyn site(N=121) and addresses the relationship between self-assessed health (14 item CDC-HRQOL) and 30 personal, provider or structural barriers to care (yes/no). We describe the relationships between health and barriers to seeking care. Findings: Mean age was 38.9 (SD=11.7). 81% were of African descent, 8% Latina, and 11% biracial/other. 70.3% were single, 22.7% in unstable housing, 17.7 % living with children, 50.9% high school or higher education, 15.8% employed or in school, and 83.5% receive Medicaid. Fourteen of 30 (46.7%) barriers were noted as present by 50% or more of the sample: 5/9 (55.6%) provider barriers; 6/12 (50.0%) personal barriers; and 3/9 (33.3%) structural barriers. Personal barriers and structural barriers were associated (p≤.05) with most HRQOL items (healthy days last 30 days, activity limitations, and symptoms of pain, depression, anxiety) including global health and inversely correlated with a measure of feeling healthy; provider barriers were associated with items about activity limitations, pain and others taking care of routine needs. Conclusions: poor physical and mental health contribute to women's health seeking; approaches considering already diminished health status may assist efforts bringing women into HIV care.