Coping with a dual diagnosis: Healthcare beliefs and attitudes among ethnic minority HIV-positive female substance abusers with a chronic illness

Substance abusers with HIV are living longer as a result of continuing advances in treatment but are also facing an increased risk for chronic diseases. These conditions add to their health concerns resulting in a larger burden of hospitalization, outpatient, and emergency room visits. Impoverished ethnic minority women may represent an especially high-risk group for chronic illnesses due to disparities in health care, racial discrimination, and limited resources. Using the socio-ecological model as a guiding framework, this pilot study sought to explain how Black and Hispanic female substance abusers faced with a dual diagnosis of HIV and a chronic illness defined and conceptualized their own health; and to identify their beliefs and attitudes towards seeking health care from their own unique perspective. Data was collected using four focus groups (N=48), and a brief demographic questionnaire. Content analysis revealed that a repertoire of individual (knowledge, attitudes, and beliefs towards health, locus of control, and self efficacy in their ability to seek and receive care), interpersonal (social and lifestyle norms, and social support for maintaining good health), and environmental (availability and access to culturally-relevant health education programs) factors may have an impact on the health seeking behaviors of this population. The findings suggest that comprehensive on-going services that not only include culturally sensitive education components, but also strengthen and facilitate an individual's existing personal, social, psychological, and environmental support networks are needed to improve health outcomes among ethnic minority female substance abusers faced with the comorbidities of HIV and a chronic disease.