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Sociocultural and Structural Barriers to Care Among Undocumented Latino Immigrants with HIV Infection

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Abstract

Timely entry into HIV care is critical for early initiation of therapy, immunologic recovery and improved survival. However, undocumented Latinos are more likely to enter HIV care late in the disease course and with concurrent AIDS. We conducted a qualitative study to examine the circumstantial, situational and social factors that uniquely affect entry and retention in care for this population. Between June and August 2006, we conducted semi-structured, in-depth, individual interviews with 22 undocumented Latino immigrants living with HIV infection. The interviews were audiotaped, transcribed and reviewed for accuracy. Data was analyzed using a grounded theory approach. Word content was coded and sorted by themes using AnSWR software. Emergent themes related to health care barriers include (1) the challenges of dealing with HIV stigma and rejection from family and community; and (2) the experienced and perceived structural barriers of accessing care as an undocumented individual. Societal intolerance of HIV and stigma-related experiences result in feelings of secrecy and shame. In addition, the undocumented state complicates the situation even further. These unique barriers include fear of deportation, work restrictions, inadequate translation services and difficulties meeting paperwork requirements. This study offers insight into the unique sociocultural and structural barriers faced by undocumented Latinos with HIV infection. Understanding and addressing these barriers will prove vital in the development and implementation of strategies to promote early entry into HIV care.

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Acknowledgments

The project was funded by the Houston Regional HIV/AIDS Resource Group, Grant HRSA-08-089 from the US Health Resources and Services Administration (HRSA) under Part A of the Ryan White HIV/AIDS Treatment Modernization Act’s HIV Emergency Relief Grant Program, and the facilities and resources of the Houston VA Health Services Research & Development Center of Excellence, Michael E. DeBakey VA Medical Center and the Harris County Hospital District, Houston, TX.

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The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

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Authors and Affiliations

  1. Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Bich N. Dang & Thomas P. Giordano

  2. VA Health Services Research & Development Center of Excellence, Michael E. DeBakey VA Medical Center (152), 2002 Holcombe Blvd, Houston, TX, 77030, USA

    Bich N. Dang & Thomas P. Giordano

  3. Harris County Hospital District, Houston, TX, USA

    Bich N. Dang & Thomas P. Giordano

  4. Houston Ryan White Planning Council, Houston, TX, USA

    Jennifer H. Kim

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  1. Bich N. Dang
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  2. Thomas P. Giordano
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  3. Jennifer H. Kim
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Correspondence to Bich N. Dang.

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Dang, B.N., Giordano, T.P. & Kim, J.H. Sociocultural and Structural Barriers to Care Among Undocumented Latino Immigrants with HIV Infection. J Immigrant Minority Health 14, 124–131 (2012). https://doi.org/10.1007/s10903-011-9542-x

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  • DOI: https://doi.org/10.1007/s10903-011-9542-x

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