Open AccessSocial and Structural Barriers to Primary Care Access Among Women Living With HIV in Metro Vancouver, Canada: A Longitudinal Cohort Study
Author(s) -
Kathleen Deering,
Louise Chong,
Patricia A. Duff,
Lulu Gurney,
Patience Magagula,
Mei-ling Wiedmeyer,
Jill Chettiar,
Melissa Braschel,
Karan D’Souza,
Kate Shan
Publication year - 2021
Publication title -
the journal of the association of nurses in aids care/journal of the association of nurses in aids care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.636
H-Index - 49
eISSN - 1552-6917
pISSN - 1055-3290
DOI - 10.1097/jnc.0000000000000234
Subject(s) - odds , medicine , primary care , longitudinal study , cohort , mental health , cohort study , gerontology , suicidal ideation , social support , human immunodeficiency virus (hiv) , odds ratio , demography , environmental health , poison control , family medicine , suicide prevention , psychiatry , psychology , logistic regression , pathology , sociology , psychotherapist
This study examines correlates of being unable to access primary care in the past 6 months among cisgender (cis) and trans women living with HIV (WLWH). Data were drawn from a longitudinal community-based cohort study of WLWH (ages 14+) in Metro Vancouver, Canada (2014-2017). Of 291 participants contributing 914 observations, 15.5% reported being unable to access primary care at baseline. In multivariable analysis, increased odds of being unable to access primary care was associated with (a) having im/migrated to Canada, and, in the past 6 months, (b) identifying as gender minority, (c) experiencing physical or sexual violence, (d) having suicidal ideation or attempts. Decreased odds were associated with recently accessing HIV-specific resources. Our findings suggest that primary health care for WLWH should address high levels of violence and mental health conditions as well as barriers to services for gender minority and im/migrant WLWH.