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Structural Barriers to Women’s Sustained Engagement in HIV Care in Southern California

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Abstract

Since the introduction of antiretroviral therapy, the number of women living with HIV (WLHIV) continues to increase. Despite the decrease in HIV diagnosis among women in California, less than half of WLHIV are retained in HIV care. Structural barriers put women at increased risk for delayed HIV diagnosis, delayed entry into HIV care, and poorer treatment outcomes. The objective of this qualitative analysis is to identify how structural barriers negatively impact women’s sustained engagement in HIV care in Southern California. WLHIV accessing local HIV support services participated in a qualitative study by completing a semi-structured interview and brief survey between January and April 2015 (n = 30). Poverty, unemployment, housing instability, and needs for transportation emerged as the dominant structural barriers for women when discussing their challenges with sustained engagement in HIV care. System-level interventions that decrease these noted barriers may help improve HIV care continuum for women living in Southern California.

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Acknowledgements

The authors acknowledge the clients and peer navigators of a local HIV service agency in San Diego, California for their participation to this research. JKS received partial support by award number UL1TR000100 from the National Center for Advancing Translational Sciences, and the Altman Clinical and Translational Research Institute Academic-Community Partnership Pilot Project Grant at the University of California, San Diego. LRS was supported by award number K01 DA039767 from the National Institute on Drug Abuse. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

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Authors and Affiliations

  1. Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA

    Eunhee Park

  2. Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA

    Jamila K. Stockman, Briana Thrift, Ava Nicole & Laramie R. Smith

  3. Division of Epidemiology, San Diego State University Graduate School of Public Health, San Diego, CA, USA

    Briana Thrift

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  1. Eunhee Park
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Correspondence to Laramie R. Smith.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was conducted with the approval by the Human Research Protection Program of the University of California, San Diego.

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Park, E., Stockman, J.K., Thrift, B. et al. Structural Barriers to Women’s Sustained Engagement in HIV Care in Southern California. AIDS Behav 24, 2966–2974 (2020). https://doi.org/10.1007/s10461-020-02847-9

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