290645
What keeps me out of care? perspectives of PLWHA in rural South Carolina
Donna L. Richter, EdD, FAAHB
,
Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
Medha Vyavaharkar, PhD, MPH, MD, DNB
,
department of Health Services Policy and Management, Arnold School of Public Health, Columbia, SC
Lucy Annang, PhD, MPH
,
Department of Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, Columbia, SC
Leah Williams, DrPH, MPH
,
Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
Saundra H. Glover, PhD, MBA
,
Director, Instittute for Partnerships to Eliminate Health Disparities, University of South Carolina-Arnold School of Public Health (Department of Health Services Policy and Management), Columbia, SC
Background: Nationally, approximately 77% of those who know their positive HIV status are linked to care within 3 months and only 51% are retained in care. Studies in South Carolina indicated that 48% entered care within 3 months of the diagnosis and only 35% remained in care after 3 years. Early initiation of care and continued engagement in care optimize HIV treatment success for individuals and can decrease transmission of HIV to others by significantly lowering the viral load. Given this, identifying barriers to seeking and maintaining care is critical. This study investigated personal, organizational, and environmental factors that inhibit care initiation and care continuity among persons living with HIV/AIDS (PLWHA) residing in a rural, predominantly minority county in South Carolina. Methods: As part of an NIH-funded study, interviews with PLWHA not in care for at least 6 months were conducted by a trained interviewer who is a trusted local resident living with HIV. Interviews were audio-recorded and transcribed verbatim. NVivo 9 software was used to analyze the data to identify major themes. Results: Multiple barriers to initiating and continuing care were identified. Regarding the health care system, organization environment and culture, staffing policies, availability of infectious disease doctor, and patient-provider interactions were some of the important themes that emerged from the interviews. Interview participants suggested changes in the health care delivery system that would facilitate their continuation in care. Conclusion: Findings identify potential points of interventions to improve rates of initiation of and retention in care among PLWHA.
Learning Areas:
Provision of health care to the public
Learning Objectives:
List factors that keep PLWHA from seeking medical care
Formulate suggestions for removing such barriers to initiating and continuing care
Keywords: Access to Health Care, HIV/AIDS
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I have served as PI on multiple grants on HIV/AIDS funded by NIH, CDC, HRSA, and other funders. I served for many years as Associate Editor of the journal "AIDS Education and Prevention." I have developed and taught courses on HIV prevention for approximately 25 years. I was a Fulbright Senior Research Fellow on HIV prevention in Sierra Leone, West Africa.
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.
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