“They make me feel I am worth it”: Interactions with healthcare providers and retention in HIV care for HIV+ MSM in Puerto Rico
Expressions of HIV stigma such as prejudice and discrimination among healthcare providers (HCP) have been associated with challenges in patient’s adherence and continuity in care. This is particularly true for HIV+ men who have sex with men (MSM) who are otherwise disenfranchised in health services. Research has shown that HCP’s professional competency and knowledge about HIV and sexual diversity positively influences provider-patient relationships. However, very limited research has been conducted on how stigma impacts the healthcare provider-patient relationship and retention in HIV care, particularly among HIV+MSM in Puerto Rico (PR). A qualitative study following a life history approach was conducted using semi-structured interviews with 18 HIV+MSM. Interviews included questions about experiences with HIV testing and treatment, engagement in care, and healthcare providers. Interviews were transcribed and content and discourse analyses informed by grounded theory were completed. Participants reported that HCP’s HIV knowledge, a positive and non-judgemental approach to sexuality, and a familial interaction were essential to build trust and deciding about continuing healthcare. Issues of confidentiality, limited time dedicated to clinical encounters, and discrimination based on sexual orientation and HIV status were commonly reported as barriers to continue HIV care. Proper engagement in care is essential to the wellbeing and quality of life of people living with HIV. Nonetheless, stigma experiences in provider-patient relationships negatively affect the retention in the continuum of HIV care of HIV+MSM in PR. Future interventions should invest in culturally-appropriate training for HCPs on HIV care, sexual health, and how to provide appropriate services to gay men and other MSM
Provision of health care to the public
Public health or related education
Public health or related research
Social and behavioral sciences
Describe how stigma impacts the healthcare provider-patient relationship and retention in HIV care, particularly among HIV+MSM in Puerto Rico(PR).
Discuss examples of how stigma experiences in provider-patient relationships negatively affect the retention in the continuum of HIV+MSM in Puerto Rico
Keyword(s): HIV/AIDS, Latinos
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: For the past ten years Iâve been involved in different public health scenarios. I have worked with the homeless population in PR, with health care needs within the LGBT community and lastly, with the HIV-positive population. For the past four years Iâve worked with Puerto Ricoâs Health Department-HIV Surveillance Program and with research related to stigma and HIV+MSM. Currently Iâm a second year graduate student completing a DrPH with specialty in Social Determinants of Health.
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.