A qualitative study conducted with people who have tested HIV-positive but never had HIV medical care in the United States has found that many of these individuals had poor experiences with testing, counselling and referral services. Health professionals were not always perceived to be compassionate, helpful or available, researchers from the Centers for Disease Prevention and Control (CDC) report in the June issue of AIDS Education and Prevention.
Most of the participants were poor and often had no health insurance. Interviewees felt that the structural barriers to accessing healthcare were considerable.
Failure to link people who have tested HIV positive with specialist care after diagnosis is a concern in many countries, but a particular issue in the United States. Around 25% of newly-diagnosed individuals are not successfully linked to HIV care within six to twelve months of their diagnosis, and between 10%-20% of patients remained unengaged in care three to five years later.
While some studies have looked at retention in care, very little research has investigated the factors associated with never accessing medical care.
One study from New York found that people who never entered care or were slow to do so found that they were more likely to be of non-white ethnicity and to have been diagnosed at a community testing site.
The qualitative study described here is part of a larger CDC project, the Never in Care Pilot Project, of which the quantitative findings are yet to be released. Researchers attempted to make contact with individuals who had previously tested positive for HIV but who had not entered HIV medical care in Indiana, Philadelphia and Washington State.
