A Qualitative Study of the Barriers and Facilitators to Retention-in-Care Among HIV-Positive Women in the Rural Southeastern United States: Implications for Targeted Interventions
- 1 August 2010
- journal article
- research article
- Published by Mary Ann Liebert Inc in AIDS Patient Care and STDs
- Vol. 24 (8), 515-520
- https://doi.org/10.1089/apc.2010.0065
Abstract
Retention in HIV medical care has been recognized as critical for long-term favorable clinical outcomes among HIV-positive patients. However, relatively little is known about specific factors related to HIV medical care adherence among HIV-positive women in rural areas in the United States, where the epidemic is rapidly growing among minorities and women. The objective of the current study was to assess barriers and facilitators to HIV clinic visit adherence among HIV-positive women in the rural southeastern region of the United States. Forty HIV-positive women were recruited from four outpatient clinics providing services to HIV-positive patients residing in 23 predominately rural counties in Alabama. Four focus groups were conducted ranging from 5 to 16 participants each. Content analysis was used to analyze and interpret the data. Data coding and sorting was conducted using QRS NVivo 8© software. Participants were predominately African American (92.3%) ranging in age from 29 to 69 years (mean = 46.1 years). On average, participants reported living with HIV for 8.8 years. Factors that impacted participants' ability to maintain clinic visit appointments included personal, contextual, and community/environmental factors that included: patient/provider relationships, family support, access to transportation, organizational infrastructure of the health care facility visited and perceived HIV stigma within their communities. The current study highlights the myriad of retention-in-care barriers faced by HIV-positive women living in rural areas in the southeastern United States. Innovative multilevel interventions that address these factors are sorely needed to increase long-term retention-in-care among HIV-positive women residing in rural areas.Keywords
This publication has 16 references indexed in Scilit:
- Gender Differences in Discontinuation of Antiretroviral Treatment RegimensJAIDS Journal of Acquired Immune Deficiency Syndromes, 2009
- Race and Sex Differences in Antiretroviral Therapy Use and Mortality among HIV‐Infected Persons in CareThe Journal of Infectious Diseases, 2009
- Missed Visits and Mortality among Patients Establishing Initial Outpatient HIV TreatmentClinical Infectious Diseases, 2009
- Racial Disparities in HIV Virologic Failure: Do Missed Visits Matter?JAIDS Journal of Acquired Immune Deficiency Syndromes, 2009
- Self-reported reasons among HIV-infected patients for missing clinic appointmentsInternational Journal of STD & AIDS, 2008
- Retention in Care: A Challenge to Survival with HIV InfectionClinical Infectious Diseases, 2007
- One‐year adherence to clinic visits after highly active antiretroviral therapy: a predictor of clinical progress in HIV patientsJournal of Internal Medicine, 2007
- Access to and Utilization of Primary Care Services Among HIV-Infected WomenJAIDS Journal of Acquired Immune Deficiency Syndromes, 1999
- Health Services Use by Urban Women With or at Risk for HIV-1 Infection: The HIV Epidemiology Research Study (HERS)JAIDS Journal of Acquired Immune Deficiency Syndromes, 1998
- Variation in Health Service Use Among HIV-lnfected PatientsMedical Care, 1992