Factors affecting healthcare access perceptions and care-seeking behaviors of Latino sexual minority men and transgender individuals: HOLA intervention baseline findings

Background. Latino sexual minority men and transgender individuals experience a disproportionate burden of HIV in the US. This study examined factors associated with perceptions of healthcare access and care-seeking behaviors among this population in North Carolina (NC).

Methods. A community-based participatory research (CBPR) partnership recruited 180 Latino individuals within social networks to participate in a lay health advisor sexual health intervention. Using baseline data, mixed-effects logistic regression models were performed to examine factors influencing healthcare access perceptions and behaviors.

Results. Participants were single (47%) sexual minority men (82%) and transgender (18%) individuals who lived in urban (84%) NC for approximately 8 years (SD=4.5). Rates of heavy episodic drinking (67.3%) and cocaine use (17%) were relatively high. About half had two or more male sex partners in the past six months (52%) and 37% reported condom use at last anal sex (37%). Participants rated access to urgent (49%) and non-urgent (54%) care as poor/fair. About 58% had received an HIV test in the past year and 15% had never seen a health care provider. These outcomes were significantly affected by: years lived in NC, residence in medically underserved areas, employment status, perceptions of poor general health, perceived racial and sexual discrimination, and micro- (e.g., knowledge), meso- (e.g., cost), and macro- (e.g., immigration status) level barriers (p<0.05).

Discussion. To improve the sexual health of Latino sexual minority men and transgender individuals, focus must be placed on multiple levels, including individual characteristics (e.g., education), clinic factors (e.g., hours), and structural (e.g., discrimination) factors.