Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania.
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, New York.
AIDS Educ Prev. 2022 Oct;34(5):349-364. doi: 10.1521/aeap.2022.34.5.349.
One-quarter of gay, bisexual, and other men who have sex with men (GBMSM) with diagnosed HIV are not engaged in HIV care. Between 2018 and 2019, 50 GBMSM completed qualitative interviews 3 months after receiving an HIV-positive result. Interviews explored barriers to and facilitators of engagement and retention in HIV testing and care. Thematic analysis revealed five major themes: (1) reason for HIV testing (e.g., self-testing), (2) linkage to care (e.g., appointment/logistic issues and social support as encouragement), (3) barriers to engagement in care (e.g., financial burden, competing priorities, and fear/stigma), (4) facilitators of engagement (e.g., financial assistance, patient-provider relationships, auxiliary support services, and health agency), and (5) PrEP as a missed prevention opportunity. Addressing individual-, social-, and policy-level barriers could improve GBMSM's engagement in HIV care. Further, capitalizing on GBMSM's health agency through partnerships with local agencies and fostering better patient-provider relationships could optimize HIV care continuity.
四分之一被诊断出 HIV 的男同性恋、双性恋和其他与男性发生性关系者(GBMSM)未参与 HIV 护理。在 2018 年至 2019 年期间,有 50 名 GBMSM 在收到 HIV 阳性结果后 3 个月完成了定性访谈。访谈探讨了参与和维持 HIV 检测和护理的障碍和促进因素。主题分析揭示了五个主要主题:(1)HIV 检测的原因(例如,自我检测),(2)与护理的联系(例如,预约/后勤问题和社会支持作为鼓励),(3)参与护理的障碍(例如,经济负担、竞争优先事项和恐惧/耻辱感),(4)参与的促进因素(例如,经济援助、医患关系、辅助支持服务和卫生机构),以及(5)PrEP 作为错失的预防机会。解决个人、社会和政策层面的障碍可以提高 GBMSM 参与 HIV 护理的积极性。此外,通过与当地机构建立伙伴关系并培养更好的医患关系,利用 GBMSM 的健康机构,可以优化 HIV 护理的连续性。