Provider Perceptions of Barriers to HIV Care Among Women with HIV in Miami-Dade County, Florida, and Possible Solutions: A Qualitative Study

Author:

Ward Melissa K.12ORCID,de la Cruz Yazmine3,Fernandez Sofia B.24,Ibañez Gladys E.12,Jean-Gilles Michèle1,Dévieux Jessy G.12,Brock Petra5,Ladner Robert6,Beach Mary Catherine7,Trepka Mary Jo12ORCID

Affiliation:

1. Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA

2. Research Center in Minority Institutions, Florida International University, Miami, FL, USA

3. College of Osteopathic Medicine—Southern Utah, Rocky Vista University, Ivins, UT, USA

4. School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA

5. Deft Research, Minneapolis, MN, USA

6. Behavioral Science Research Corporation, Coral Gables, FL, USA

7. Johns Hopkins University School of Medicine, Baltimore, MD, USA

Abstract

In Miami-Dade County, women with HIV (WWH) enrolled in Ryan White Program (RWP) services belong to groups that have historically faced structural barriers to care. To examine provider perceptions of WWH's barriers to care and elicit possible solutions, we conducted semi-structured interviews (n = 20) with medical case managers and human immunodeficiency virus (HIV) healthcare providers from medical case management sites serving WWH enrolled in the Miami-Dade RWP. Verbatim transcripts were analyzed thematically by two coders through an iterative process; disagreements were resolved through consensus. Barriers included lack of disclosure and stigma, additional psychosocial barriers to care, structural and logistical barriers, and negative interactions with health care providers. Participant suggestions to address these barriers included strategies that support women and foster individualized services that are responsive to their lived experiences and needs. Other solutions, such as those related to transportation, housing, and general funding for the RWP, will require advocacy and policy change.

Funder

National Institute on Minority Health and Health Disparities

Publisher

SAGE Publications

Subject

Infectious Diseases,Dermatology,Immunology

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