Barriers and Facilitators to HIV Service Access among Hispanic/Latino Gay, Bisexual, and Other Men Who Have Sex with Men in Metropolitan Atlanta-a Qualitative Analysis.
Rashida Hassan, Carlos S Saldana, Eleanor W Garlow, Mariana Gutierrez, Rebecca B Hershow, Dena Elimam, Jose F Adame, Jonny F Andía, Mabel Padilla, Nathalie Gonzalez Jimenez, Dorian Freeman, Erica N Johnson, Karrie Reed, David P Holland, Humberto Orozco, Gilda Pedraza, Craig Hayes, David C Philpott, Kathryn G Curran, Pascale Wortley, Christine Agnew-Brune, Jenna R Gettings
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引用次数: 0
Abstract
Hispanic/Latino persons are disproportionately impacted by HIV in the US, and HIV diagnoses among Hispanic/Latino men in Georgia have increased over the past decade, particularly in metropolitan Atlanta. In 2022, the Georgia Department of Public Health detected five clusters of rapid HIV transmission centered among Hispanic/Latino gay, bisexual, and other men who have sex with men (HLMSM) in metropolitan Atlanta. We conducted in-depth interviews with 65 service providers and 29 HLMSM to identify barriers and facilitators to HIV service access for HLMSM. Interviews were audio recorded, transcribed, and translated, if needed. Initial data analyses were conducted rapidly in the field to inform public health actions. We then conducted additional analyses including line-by-line coding of the interview transcripts using a thematic analytic approach. We identified four main themes. First, inequity in language access was a predominant barrier. Second, multiple social and structural barriers existed. Third, HLMSM encountered intersectional stigma. Finally, the HLMSM community is characterized by its diversity, and there is not a one-size-fits-all approach to providing appropriate care to this population. The collection of qualitative data during an HIV cluster investigation allowed us to quickly identity barriers experienced by HLMSM when accessing HIV and other medical care, to optimize public health response and action. Well-designed program evaluation and implementation research may help elucidate specific strategies and tools to reduce health disparities, ensure equitable service access for HLMSM, and reduce HIV transmission in this population.
期刊介绍:
The Journal of Urban Health is the premier and authoritative source of rigorous analyses to advance the health and well-being of people in cities. The Journal provides a platform for interdisciplinary exploration of the evidence base for the broader determinants of health and health inequities needed to strengthen policies, programs, and governance for urban health.
The Journal publishes original data, case studies, commentaries, book reviews, executive summaries of selected reports, and proceedings from important global meetings. It welcomes submissions presenting new analytic methods, including systems science approaches to urban problem solving. Finally, the Journal provides a forum linking scholars, practitioners, civil society, and policy makers from the multiple sectors that can influence the health of urban populations.