Barriers and Facilitators of HIV Care Engagement: Results of a Qualitative Study in St. Petersburg, Russia

• Published in: AIDS and behavior Vol. 20; no. 10; pp. 2433 - 2443
• Main Authors: Kuznetsova, Anna V., Meylakhs, Anastasia Y., Amirkhanian, Yuri A., Kelly, Jeffrey A., Yakovlev, Alexey A., Musatov, Vladimir B., Amirkhanian, Anastasia G.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-10-2016; Springer Nature B.V
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Anti-HIV Agents - therapeutic use; Barriers; Communication; Constraints; Continuity of Patient Care - statistics & numerical data; Death & dying; Discontent; Drug abuse; Epidemics; Female; Health; Health care; Health problems; Health Psychology; Health services; Health Services Accessibility - statistics & numerical data; Health Status; HIV; HIV Infections - drug therapy; HIV Infections - psychology; Human immunodeficiency virus; Humans; Illnesses; Infectious Diseases; Interviews as Topic; Lentivirus; Male; Medication Adherence - statistics & numerical data; Medicine; Medicine & Public Health; Middle Aged; Original Paper; Patient Acceptance of Health Care - statistics & numerical data; Public Health; Qualitative Research; Quality of care; Remission; Retroviridae; Russia - epidemiology; Social Stigma; Social Support; Stigmas (botany); Substance abuse; Substance use; Substance-Related Disorders - complications; Substance-Related Disorders - psychology; Symptoms; Russia; INW, Russia; Persons living with HIV (PLHIV); HIV-positive; HIV care linkage and retention; HIV medical care; HIV services; Russia
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-015-1282-9

Russia has a large HIV epidemic, but medical care engagement is low. Eighty HIV-positive persons in St. Petersburg completed in-depth interviews to identify barriers and facilitators of medical HIV care engagement. The most commonly-reported barriers involved difficulties accessing care providers, dissatisfaction with the quality of services, and negative attitudes of provider staff. Other barriers included not having illness symptoms, life stresses, low value placed on health, internalized stigma and wanting to hide one’s HIV status, fears of learning about one’s true health status, and substance abuse. Care facilitators were feeling responsible for one’s health and one’s family, care-related support from other HIV-positive persons, and the onset of health decline and fear of death. Substance use remission facilitated care engagement, as did good communication from providers and trust in one’s doctor. Interventions are needed in Russia to address HIV care infrastructural barriers and integrate HIV, substance abuse, care, and psychosocial services.