Barriers to health care services for migrants living with HIV in Spain

European Journal of Public Health
Volume 28, Issue 3, 2018, Pages 451-457

Barriers to health care services for migrants living with HIV in Spain (Article) (Open Access)

Ndumbi P.* , Del Romero J. , Pulido F. , Velasco Arribas M. , Dronda F. , Blanco Ramos J.R. , García De Olalla P. , Ocaña I. , Belda-Ibañez J. , Del Amo J. , Álvarez-Del Arco D. , Gennotte A.-F. , Barthélemy C.L.M. , Wengenroth C. , Touloumi G. , Ilias G. , Loumpiana K. , Olga A. , Schüttfort G. , Wenganroth C. , Barros H. , Meireles P. , Álvarez D. , Monge S. , Ledergerber B. , Staehelin C. , Prins M. , Bill J. , Zuure F. , Prestileo T. , Petrosillo N. , Burns F. , Fakoya I. , Del Romero J J. , Rodríguez C. , Vera M. , Río I. , Paredes V. , Sanz N. , Arribas M.V. , Mateo M.G. , Gutiérrez M. , Domingo P. , Knobel H. , Pellicer T. , Fernández E. , Del Carmen Ligero M. , Robau M. , Miró J.M. , Burgos J. , Barberà M.J. , Arando M. , Gutiérrez F. , Masía M. , Blanco J.R. , Belda-Ibáñez J. , García E.F. , Espinosa T.Z. , López-Lirola A. , Salavert M. , Montero M. , Calabuig E. , Cuellar S. , Vinciana P. , Palacios R. , García F. , Peña A. , Iribarren J.A. , Aguado M. , Portillo Á. , Gómez-Sirvent J.L.

^a National Center of Epidemiology, Insituto de Salud Carlos III, Avda. Monforte de Lemos, 5, Madrid, 28029, Spain
^b Centro Sanitario Sandoval, Madrid, Spain
^c Hospital Universitario Doce de Octubre, Universidad Complutense de Madrid i + 12, Madrid, Spain; Hospital Universitario Doce de Octubre, Universidad Complutense de Madrid i + 12, Madrid, Spain
^d Hospital Universitario Fundación Alcorcón, Madrid, Spain
^e Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain
^f Hospital San Pedro - CIBIR, Logroño, Spain
^g Agencia de Salud Pública de Barcelona, Barcelona, Spain, Biomedical Research Network on Epidemiology and Public Health (Ciberesp), Spain
^h Hospital de la Vall d'Hebron, Barcelona, Spain;
ⁱ Centros de Información y Prevención Del Sida de Alicante, Alicante, Spain
^j National Center of Epidemiology, Insituto de Salud Carlos III, Avda. Monforte de Lemos, 5, Madrid, 28029, Spain, Biomedical Research Network on Epidemiology and Public Health (Ciberesp), Spain;
^k National Center of Epidemiology, Insituto de Salud Carlos III, Avda. Monforte de Lemos, 5, Madrid, 28029, Spain, Biomedical Research Network on Epidemiology and Public Health (Ciberesp), Spain, Faculty of Political Science and Sociology, Universidad Complutense de Madrid, Madrid, Spain
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Abstract

Background In Spain, migrants are disproportionately affected by HIV and experience high rates of late diagnosis. We investigated barriers to health care access among migrants living with HIV (MLWH) in Spain. Methods Cross sectional electronic survey of 765 adult HIV-positive migrants recruited within 18 health care settings between July 2013 and July 2015. We collected epidemiological, demographic, behavioral and clinical data. We estimated the prevalence and risk factors of self-reported barriers to health care using multivariable logistic regression. Results Of those surveyed, 672 (88%) had information on health care access barriers: 23% were women, 63% from Latin America and Caribbean, 14% from Sub-Saharan Africa and 15% had an irregular immigration status. Men were more likely to report barriers than women (24% vs. 14%, P = 0.009). The main barriers were: lengthy waiting times for an appointment (9%) or in the clinic (7%) and lack of a health card (7%). Having an irregular immigration status was a risk factor for experiencing barriers for both men (OR: (4.0 [95%CI: 2.2-7.2]) and women (OR: 10.5 [95%CI: 3.1-34.8]). Men who experienced racial stigma (OR: 3.1 [95%CI: 1.9-5.1]) or food insecurity (OR: 2.1 [95%CI: 1.2-3.4]) were more likely to report barriers. Women who delayed treatment due to medication costs (6.3 [95%CI: 1.3-30.8]) or had a university degree (OR: 5.8 [95%CI: 1.3-25.1]) were more likely to report barriers. Conclusion Health care barriers were present in one in five5 MLWH, were more common in men and were associated to legal entitlement to access care, perceived stigma and financial constraints. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Author Keywords

[No Keywords available]

Index Keywords

HIV Infections health care survey Health Care Surveys Human immunodeficiency virus infection human statistics and numerical data Cross-Sectional Studies Young Adult Humans cross-sectional study Adolescent male Spain female risk factor Risk Factors adult migration Transients and Migrants Health Services Accessibility health care delivery

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85048633183&doi=10.1093%2feurpub%2fckx225&partnerID=40&md5=1256db0d7d69096763b1c2d35c109065

DOI: 10.1093/eurpub/ckx225

ISSN: 11011262

Cited by: 4

Original Language: English