Examining Barriers to Medication Adherence and Retention in Care among Women Living with HIV in the Face of Homelessness and Unstable Housing

Sofia B. Fernandez (), Cindy Lopez, Cynthia Ibarra, Diana M. Sheehan, Robert A. Ladner and Mary Jo Trepka
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Sofia B. Fernandez: School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA
Cindy Lopez: Research Center in Minority Institutions (RCMI), Florida International University, Miami, FL 33199, USA
Cynthia Ibarra: Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA
Diana M. Sheehan: Research Center in Minority Institutions (RCMI), Florida International University, Miami, FL 33199, USA
Robert A. Ladner: Behavioral Science Research Corp., Coral Gables, FL 33134, USA
Mary Jo Trepka: Research Center in Minority Institutions (RCMI), Florida International University, Miami, FL 33199, USA

IJERPH, 2022, vol. 19, issue 18, 1-14

Abstract: Despite advances in biomedical treatments, women living with HIV (WLH) who experience homelessness and housing instability suffer suboptimal HIV outcomes, even when linked to treatment. The purpose of this study was to explore experiences of housing instability among WLH and to understand its role in their ability to adhere to antiretroviral medication and remain retained in care. Sixteen women who were linked to Ryan White Program HIV care in South Florida participated in in-depth interviews. The findings focus around four larger themes: difficulty storing medication, privacy- and stigma-related issues, inconsistent access to medication and health care disruptions, and competing and unmet physical and mental health needs. Findings underscore the importance of strategies that are responsive to the disruption of routines and are sensitive to privacy issues in shared dwelling spaces; the proactive inquiry of behavioral and environmental considerations when prescribing antiretroviral medication; and the identification and treatment of comorbid conditions. This study provides evidence for strategies to facilitate self-management and improve modifiable system realities to augment larger-level policy and funding shifts that are critically needed to end the epidemic among vulnerable populations living with HIV.

Keywords: women living with HIV; housing instability; homelessness; medication adherence; retention in care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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