AIDS and Behavior

, Volume 20, Issue 10, pp 2433–2443 | Cite as

Barriers and Facilitators of HIV Care Engagement: Results of a Qualitative Study in St. Petersburg, Russia

  • Anna V. Kuznetsova
  • Anastasia Y. Meylakhs
  • Yuri A. Amirkhanian
  • Jeffrey A. Kelly
  • Alexey A. Yakovlev
  • Vladimir B. Musatov
  • Anastasia G. Amirkhanian
Original Paper


Russia has a large HIV epidemic, but medical care engagement is low. Eighty HIV-positive persons in St. Petersburg completed in-depth interviews to identify barriers and facilitators of medical HIV care engagement. The most commonly-reported barriers involved difficulties accessing care providers, dissatisfaction with the quality of services, and negative attitudes of provider staff. Other barriers included not having illness symptoms, life stresses, low value placed on health, internalized stigma and wanting to hide one’s HIV status, fears of learning about one’s true health status, and substance abuse. Care facilitators were feeling responsible for one’s health and one’s family, care-related support from other HIV-positive persons, and the onset of health decline and fear of death. Substance use remission facilitated care engagement, as did good communication from providers and trust in one’s doctor. Interventions are needed in Russia to address HIV care infrastructural barriers and integrate HIV, substance abuse, care, and psychosocial services.


Russia Persons living with HIV (PLHIV) HIV-positive HIV medical care HIV services HIV care linkage and retention 


Rusia experimenta una importante epidemia de VIH, pero tiene baja retención de las personas VIH positivas en la atención médica. Ochenta personas viviendo con VIH en San Petersburgo completaron entrevistas en profundidad con el fin de identificar barreras y facilitadores en cuanto a estar bajo atención médica del VIH. Las barreras más comúnmente reportadas fueron dificultades en el acceso a proveedores de salud, insatisfacción con la calidad de los servicios de salud, y actitudes negativas de los proveedores de salud. Otras barreras fueron no tener síntomas de enfermedad, experimentar otros estresores vitales, tener una baja valoración de la propia salud, experimentar estigma internalizado y necesitad de esconder el estatus VIH positivo, tener miedo a conocer el propio estado de salud, y usar sustancias. Los facilitadores de mantenerse bajo cuidado médico fueron sentirse responsable por la propia salud y la de la familia, recibir el apoyo de otras personas VIH positivas, y sentir el comienzo de la declinación de la salud y el miedo a la muerte. Además de la buena comunicación con los proveedores de salud y de tener un médico de confianza, la reducción del uso de sustancias facilitó la retención en el cuidado médico. En Rusia, se necesitan intervenciones que tengan en cuenta las barreras de infraestructura en la atención del VIH e integren los servicios de VIH con los psicosociales y de abuso de sustancias.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Anna V. Kuznetsova
    • 1
  • Anastasia Y. Meylakhs
    • 1
  • Yuri A. Amirkhanian
    • 1
    • 2
  • Jeffrey A. Kelly
    • 2
  • Alexey A. Yakovlev
    • 1
    • 3
  • Vladimir B. Musatov
    • 1
    • 3
  • Anastasia G. Amirkhanian
    • 1
  1. 1.Botkin Hospital for Infectious DiseasesInterdisciplinary Center for AIDS Research and Training (ICART)St. PetersburgRussia
  2. 2.Department of Psychiatry and Behavioral Medicine, Medical College of WisconsinCenter for AIDS Intervention Research (CAIR)MilwaukeeUSA
  3. 3.Faculty of MedicineSt. Petersburg State UniversitySt. PetersburgRussia

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