Barriers to Care & Treatment Practices in HIV+ Latinos in the US-Mexico Border Region (Proyecto Acceso)

Funded by National Institutes of Mental Health (NIMH), R21 MH084266; PI: María Luisa Zúñiga

US/Mexico Border

Binational Care

Binational Care

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The purpose of this study is to assess binational health care seeking behavior, HIV treatment utilization and barriers to HIV medical care among Latinos living with HIV who reside in the San Diego or Tijuana U.S.-Mexico border region. The project is a collaboration between: the University of California, San Diego (UCSD); San Ysidro Health Center; Agencia Familiar Binacional (AFABI) and Tijuana General Hospital. The aims of this proposal are:

  1. To assess binational health care seeking behavior and HIV treatment utilization, including access to ARVs and use of complementary and alternative medicine (e.g. traditional healers, herbs/plants, vitamin supplements) among HIV-positive Latinos who currently reside in Tijuana, Baja California, Mexico or San Diego, CA.
  2. To determine specific barriers to HIV care, including manifestations of HIV-related stigma, spirituality/religiosity, and mobility among HIV-positive Latinos who reside in Tijuana and San Diego.
  3. To explore provider and system-level barriers to continuity of HIV care and receipt of ARVs in HIV-positiveLatinos within the health care delivery context of both sides of the U.S.-Mexico border, using qualitative research methodologies.

To meet these aims, we are using a mixed methods approach to understanding barriers to care. First we conducted a quantitative survey with a total of 283 Latinos living with HIV. Participants were recruited in equal proportions from San Diego and Tijuana to complete a survey about barriers to HIV care and HIV treatment practices. Preliminary findings indicate that many patients initiate changes to their ARV therapies, additional analyses are currently underway. Quantitative findings were used to design a qualitative in-depth interview for providers of HIV services. Twenty clinicians (10 from each side) are undergoing in-depth interviews regarding their perspectives on barriers to HIV care, including the role of HIV-related stigma, and care utilization behavior observed in their HIV-positive Latino patients who live in the border region.