Portal de Periódicos da CAPES

Nonengagement in HIV Care

2013; SAGE Publishing; Volume: 12; Issue: 3 Linguagem: Inglês

10.1177/2325957412472058

2325-9582

Kavitha C. Rao, Maithe Enriquez, Tynisha C. Gantt, Mary M. Gerkovich, Aaron J. Bonham, Ron Griffin, David M. Bamberger,

Poverty, Education, and Child Welfare

Nonengagement in HIV care is a major clinical and public health challenge. To identify the risk factors and reasons, we performed (1) a retrospective study of patients admitted to the hospital with advanced HIV disease, (2) a prospective qualitative study, and (3) a population-based area-wide telephone interview. In the retrospective study, clinic care engagement was associated with age (43.9 ± 9.1 years vs 37.9 ± 7.2 years, P = .005) and improved from 23% to 44% ( P = .03) after hospitalization. Survival was higher (93% vs 73%, P = .03) among those who engaged in care. Twelve inpatients were interviewed in the qualitative study. Themes identified for nonengagement were social stigma, indifference, or lack of understanding of care needs/denial and life care issues. In the population-based study, 145 patients were interviewed. In all, 49 denied the need for HIV care and 28 denied their HIV status. Stigma, denial, and indifference or lack of understanding of need are significant barriers to care engagement.