Online Program

HIV testing access & uptake barriers of thai and ethnic minorities in northern Thailand

Monday, November 4, 2013 : 12:50 p.m. - 1:10 p.m.

G. Pamela-Renée Crawford, MPhil, SM, MS, PhD, International Health Department, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
Robert S. Lawrence, MD, Center for a Livable Future Professor, Johns Hopkins University, Baltimore, MD
Nancy K. Roderer, MLS, Division of Health Science Informatics, Johns Hopkins University School of Medicine, Baltimore, MD
David D. Celentano, ScD, MHS, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Objective: To better understand barriers obstructing access to HIV testing in Northern Thailand. Background: Using qualitative data from Thailand's Project Accept, access barriers to HIV testing experienced by Thai and ethnic minority participants were determined. Methods: Qualitative research methods (open and focused coding, theme development, memoing and integrative-memoing, conceptual framework construction) were applied to semi-structured in-depth interview transcripts using Atlast.ti and Microsoft Office software. Study sample (n=117, aged 18-32 years) included Thai (n=81) and ethnic minorities (n=36) representing Chinese, Pakistani, Thai-Yai, Black & Red Lahu, Lisu, Hmong, Akha, Karen, Zam and Kon-Muang ethnicities. Results: Primary HIV testing barriers were primarily due to fear and misperceptions. Fears included: needles used in testing, testing alone with no emotional support, results not being private, stigma/discrimination (e.g. belief one would be disowned by one's family, and isolated from one's community, if found HIV positive), HIV-diagnosis with no treatment options (i.e. HIV viewed as a death sentence). Testing barriers due to misperceptions included: testing perceived to be expensive (many were unaware free testing was available); perception no HIV treatment was available/existed (treatment is available to Thai nationals but not ethnic minorities), time for testing and waiting for results (although rapid testing was available in some locations). Physical access to testing a site was another barrier to testing. Conclusion: Many access barriers to HIV testing in Northern Thailand could be reduced by minimizing fear and misperceptions surrounding HIV through educational interventions. Future education intervention design should target fears and misperceptions to increase uptake of HIV testing.

Learning Areas:

Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Describe barriers to HIV care and services experienced by Thai and ethnic minorities in Northern Thailand Explain differences in HIV care barriers experienced between Thais and ethnic minorities Discuss some strategies to reduce HIV care barriers for communities in Northern Thailand

Keyword(s): Barriers to Care, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator of this research project on HIV health information and health behaviors in Northern Thailand for my PhD dissertation research. Among my scientific interests has been access to health services, health information gaps associated with continued high risk HIV behaviors and barriers to HIV related care.
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.