Barriers to access to care reported by women living with HIV across 27 countries

• Published in: AIDS care 2015-10, Vol.27 (10), p.1220-1230
• Main Authors: Johnson, Margaret, Samarina, Anna, Xi, He, Valdez Ramalho Madruga, José, Hocqueloux, Laurent, Loutfy, Mona, Fournelle, Marie-Josée, Norton, Michael, Van Wyk, Jean, Zachry, Woodie, Martinez, Marisol
• Format: Article
• Language: English
• Subjects: access to health care; Acquired immune deficiency syndrome; Adult; AIDS; AIDS/HIV; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Antiretroviral Therapy, Highly Active; Barriers; barriers to care; Communities; Community education; Cross-Sectional Studies; Demographics; Demography; Employment; Epidemics; Epidemiology; Female; Global Health; Health care; Health care access; Health Services Accessibility - statistics & numerical data; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - psychology; HIV treatment; Human immunodeficiency virus; Humans; Job opportunities; Occupational health; Original; Potential barriers; Prevalence; Service provision; Social Stigma; Stigma; Stigmas (botany); Surveys and Questionnaires; Women; Women's Health; Women's issues
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2015.1046416

Increased access to successful antiretroviral therapy (ART) is necessary in order to achieve an AIDS-free generation. Importantly, slightly over half of the people living with HIV are women. Small studies have described many barriers to accessing treatment and care among women living with HIV. This cross-sectional, non-interventional, epidemiological study assessed the prevalence of barriers to accessing care for women living with HIV across 27 countries, divided into four global regions. HIV-positive women attending routine clinical visits were offered the opportunity to participate in the study. Data describing the study sites and demographic characteristics of the participating women were collected. Participating women filled out questionnaires including the Barriers to Care Scale (BACS) questionnaire, on which they reported the extent to which they found each of the 12 potential barriers to accessing health care problematic. A total of 1931 women living with HIV were included in the study: 760 from Western Europe and Canada (WEC), 532 from Central and Eastern Europe (CEE), 519 from Latin America (LA), and 120 from China. The mean age of participating women was 40.1 ± 11.4 years. A total of 88.2% were currently taking ART. A total of 81.8% obtained HIV treatment under a government health plan. The most prevalent barrier to care was community HIV/AIDS stigma. Community HIV/AIDS knowledge, lack of supportive/understanding work environments, lack of employment opportunities, and personal financial resources were also highly prevalent barriers to accessing care. These findings indicate that, more than 30 years after the start of the AIDS epidemic, stigma is still a major issue for women living with HIV. Continued efforts are needed to improve community education on HIV/AIDS in order to maximize access to health care among women living with HIV.