Structural community factors and sub-optimal engagement in HIV care among low-income women in the Deep South of the USA.
Cult Health Sex
; 18(6): 682-94, 2016.
Article
in En
| MEDLINE
| ID: mdl-26670722
ABSTRACT
This study describes the ways in which poverty and other structural factors create a risk environment for sub-optimal engagement in HIV care among low-income women living with HIV in the Southern USA, contributing to existing health disparities. We conducted a qualitative study in 2012, involving in-depth interviews with 14 stakeholders (service providers and representatives of community-based organisations) and 7 focus-group discussions with 46 women living with HIV (89% African American). A thematic approach in the context of the social ecological model guided data analysis. Data were coded and analysed using NVivo qualitative software. The findings suggested that structural community factors, such as poverty, poor employment opportunities, limited access to healthcare resources, stigma, transportation challenges and access to illicit substances, may work independently and in synergy to impact women's health seeking behaviour and decision-making, thereby influencing their ability to engage in HIV care. Interventions designed to improve engagement in HIV care should address structural factors to bolster low-income women's ability to engage in care.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Patient Participation
/
Poverty
/
Women
/
Patient Acceptance of Health Care
/
HIV Infections
/
Health Personnel
Type of study:
Prognostic_studies
/
Qualitative_research
Aspects:
Determinantes_sociais_saude
/
Patient_preference
Limits:
Adult
/
Female
/
Humans
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
Cult Health Sex
Journal subject:
CIENCIAS DO COMPORTAMENTO
/
CIENCIAS SOCIAIS
Year:
2016
Document type:
Article
Affiliation country:
United States