Social and Structural Determinants of HIV Treatment and Care Among Hispanic Women and Latinas Living with HIV Infection in the United States: A Qualitative Review: 2008-2018

Angelica Geter Fugerson, Madeline Y Sutton, Donna Hubbard McCree, Angelica Geter Fugerson, Madeline Y Sutton, Donna Hubbard McCree

Abstract

Purpose: In 2017, among all women in the United States, Hispanic women and Latinas (Hispanics/Latinas) accounted for 16% of women with HIV. Populations with high HIV disparities, including Hispanics/Latinas, experience treatment and care outcomes that are well below the national goals. The objective of this qualitative review was to identify social and structural barriers to HIV care from the perspective of Hispanics/Latinas. Methods: Our qualitative review was conducted in six stages: (1) searched and reviewed studies with a focus on Hispanics/Latinas with diagnosed HIV in the United States, published between January 2008 and August 2018; (2) removed unpublished reports and dissertations; (3) limited the search to keywords linked to social and structural HIV outcomes; (4) limited our search to studies that included samples of ≥30% Hispanics/Latinos and ≥30% female; (5) extracted and summarized the data; and (6) conducted a contextual review to identify common themes. Results: We identified 1796 articles; 84 titles and abstracts were screened for full-text review; 16 were selected for full review; and 6 articles met our inclusion criteria for final analysis. Barrier themes to HIV care for Hispanics/Latinas included HIV-related stigma from health professionals, legal consequences of seeking HIV services (including fear of deportation), and language barriers while utilizing HIV services and medications. Conclusion: Although the evidence addressing facilitators and barriers to care among HIV-positive women is sparse, interventions, resources, and enhanced training for health professionals to decrease social and structural barriers to HIV services for Hispanics/Latinas are warranted.

Keywords: HIV; HIV disparities; HIV-positive persons; Hispanic/Latino; women.

Conflict of interest statement

No competing financial interests exist.

© Angelica Geter Fugerson et al. 2019; Published by Mary Ann Liebert, Inc.

Figures

FIG. 1.
FIG. 1.
Selection process for qualitative review of the literature, HIV care outcomes among Hispanic Women/Latinas living with diagnosed HIV infection, 2008–2018. *The literature search included the following databases: PubMed, PsycINFO, Scopus, Embase, Global Health, OVID/Medline, and Google Scholar. **One study focused on multiple HIV treatment and care categories. ART, antiretroviral therapy.

References

    1. Cohen MS, Chen YQ, McCauley M, et al. . Prevention of HIV-1 infection with early antiretroviral therapy. Mass Med Soc. 2011;365:493–505
    1. Cohen MS, Chen YQ, McCauley M, et al. . Antiretroviral therapy for the prevention of HIV-1 transmission. N Engl J Med. 2016;375:830–839
    1. Rodger AJ, Cambiano V, Bruun T, et al. . Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA. 2016;316:171–181
    1. Bavinton BR, Pinto AN, Phanuphak N, et al. . Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study. Lancet HIV. 2018;5:e438–e447
    1. Rodger AJ, Cambiano V, Bruun T, et al. . Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, obersvational study. Lancet. 2019;393:2428–2438
    1. Office of National AIDS Policy. National HIV/AIDS Strategy for the United States: Updated to 2020. Washington, DC: Department of Health and Human Services; 2015. Available at Accessed October25, 2018
    1. United States Department of Health and Human Services. Ending the HIV Epidemic: A Plan for America. 2019. Available at Accessed March27, 2019
    1. Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2016. HIV Surveillance Supplemental Report. 2018;23 Available at Accessed October25, 2018
    1. Geter A, Sutton MY, Durham MD, et al. . Trends of racial and ethnic disparities in virologic suppression among women in the HIV Outpatient Study, USA, 2010–2015. PLoS One. 2018;13:e0189973.
    1. Centers for Disease Control and Prevention. HIV Surveillance Report, 2017. 2018;29 Available at Accessed March27, 2019
    1. Korhonen LC. Unmet needs for ancillary services among Hispanics/Latinos receiving HIV Medical Care—United States, 2013–2014. MMWR. 2016;65:1104–1107
    1. Brown ER, Ojeda VD, Wyn R, et al. . Racial and Ethnic Disparities in Access to Health Insurance and Health Care. Kaiser Family Foundation, 2000. Available at Accessed March26, 2019
    1. Bustamante A, Fang H, Rizzo JA, et al. . Heterogeneity in health insurance coverage among US Latino adults. J Gen Intern Med. 2009;24:561–566
    1. Garcés IC, Scarinci IC, Harrison L. An examination of sociocultural factors associated with health and health care seeking among Latina immigrants. J Immigr Health. 2006;8:377–385
    1. Amaro H, Raj A. On the margin: power and women's HIV risk reduction strategies. Sex Roles. 2000;42:723–749
    1. Marín BV. HIV prevention in the Hispanic community: sex, culture, and empowerment. J Transcult Nurs. 2003;14:186–192
    1. Scott D. Tuberculosis, sexually transmitted diseases, HIV, and other infections among farmworkers in the eastern United States. In: Latino Farmworkers in the Eastern United States 2009. New York, NY: Springer, pp. 131–152. Available at Accessed October23, 2019
    1. Gurman TA, Becker D. Factors affecting Latina immigrants' perceptions of maternal health care: findings from a qualitative study. Health Care Women Int. 2008;29:507–526
    1. Geter A, Sutton MY, Hubbard McCree D. Social and structural determinants of HIV treatment and care among black women living with HIV infection: a systematic review: 2005–2016. AIDS Care. 2018;30:409–416
    1. Hall HI, Frazier EL, Rhodes P, et al. . Differences in human immunodeficiency virus care and treatment among subpopulations in the United States. JAMA Intern Med. 2013;173:1337–1344
    1. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15:1277–1288
    1. Eaton EF, McDavid C, Banasiewicz MK, et al. . Patient preferences for antiretroviral therapy: effectiveness, quality of life, access and novel delivery methods. Patient Prefer Adherence. 2017;11:1585–1590
    1. Martinez J, Lemos D, Hosek S, et al. . Stressors and sources of support: the perceptions and experiences of newly diagnosed Latino youth living with HIV. AIDS Patient Care STDS. 2012;26:281–290
    1. Levison JH, Bogart LM, Khan IF, et al. . “Where It Falls Apart”: barriers to Retention in HIV Care in Latino Immigrants and Migrants. AIDS Patient Care STDS. 2017;31:394–405
    1. Enriquez M, Kelly PJ, Witt J, et al. . Silence is not golden: invisible Latinas living with HIV in the Midwest. J Immigr Minor Health. 2010;12:932–939
    1. Dang BN, Giordano TP, Kim JH. Sociocultural and structural barriers to care among undocumented Latino immigrants with HIV infection. J Immigr Minor Health. 2012;14:124–131
    1. McFall AM, Dowdy DW, Zelaya CE, et al. . Understanding the disparity: predictors of virologic failure in women using highly active antiretroviral therapy vary by race and/or ethnicity. J Acquir Defic Syndr. 2013;64:289–298
    1. Cianelli R, Villegas N. Social determinants of health for HIV among Hispanic women. Hisp Health Care Int. 2016;14:4–9
    1. Cesar C, Koethe JR, Reberio P, et al. . Health outcomes among HIV-positive Latinos. J Int AIDS Soc. 2016;19:1–10
    1. Kerrigan D, Mantsios A, Gorgolas M, et al. . Experiences with long acting injectable ART: a qualitative study among PLHIV participating in a Phase II study of cabotegravir + rilpivirine (LATTE-2) in the United States and Spain. PLoS One. 2018;13:e0190487.
    1. Margolis DA, Gonzalez-Garcia J, Stellbrink HJ, et al. . Long-acting intramuscular cabotegravir and rilpivirine in adults with HIV-1 infection (LATTE-2): 96-week results of a randomised, open-label, phase 2b, non-inferiority trial. Lancet. 2017;390:1499–1510
    1. Aziz M, Smith KY. Challenges and successes in linking HIV-infected women to care in the United States. Clin Infect Dis. 2011;52 Suppl 2:S231–S237
    1. Rajabiun S, Rumptz MH, Felizzola J, et al. . The Impact of Acculturation on Latinos' perceived barriers to HIV primary care. Ethn Dis. 2008;18:403–408
    1. Geter A, Herron AR, Sutton MY. HIV-related stigma by healthcare providers in the United States: a systematic review. AIDS Patient Care STDS. 2018;32:418–424
    1. Hargreaves M, Hidalgo J, Byrd V, et al. . Strategies for Engaging and Retaining Latinos in HIV Care. Mathematica Policy Research. Available at Accessed October23, 2019
    1. Blank AE, Fletcher J, Verdecias N, et al. . Factors associated with retention and viral suppression among a cohort of HIV+ women of color. AIDS Patient Care STDs. 2015;29(Suppl 1):S27–S35
    1. Kaiser Family Foundation. AIDS Drug Assistance Programs (ADAPs). 2017. Available at Accessed March27, 2019
    1. Centers for Disease Control and Prevention. Compendium of evidence-based interventions and best practices for HIV prevention. 2016. Available at Accessed March6, 2017

Source: PubMed

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