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A qualitative study on mixed experiences of discrimination and healthcare access among HIV-positive immigrants in Spain

BACKGROUND: Immigrants are disproportionally impacted by HIV infection in Europe and in Spain. Immigrants are also identified as a vulnerable population during economic crises. Various socioeconomic barriers hinder HIV-positive immigrants from accessing healthcare services in the host country. As a...

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Autores principales: Gogishvili, Megi, Flórez, Karen R., Costa, Sergio A., Huang, Terry T.-K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7893723/
https://www.ncbi.nlm.nih.gov/pubmed/33607960
http://dx.doi.org/10.1186/s12889-021-10388-6
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author Gogishvili, Megi
Flórez, Karen R.
Costa, Sergio A.
Huang, Terry T.-K.
author_facet Gogishvili, Megi
Flórez, Karen R.
Costa, Sergio A.
Huang, Terry T.-K.
author_sort Gogishvili, Megi
collection PubMed
description BACKGROUND: Immigrants are disproportionally impacted by HIV infection in Europe and in Spain. Immigrants are also identified as a vulnerable population during economic crises. Various socioeconomic barriers hinder HIV-positive immigrants from accessing healthcare services in the host country. As a result of the 2008 financial crisis, Spain has implemented multiple austerity measures, one of which was the enactments of Royal Decree Law (RDL) 16/2012 and Royal Decree (RD) 1192/2012 which abolished universal healthcare coverage. In this context, this study examined: 1) Participants’ mixed experiences in accessing health care after the enactment of 2012 RDL and RD, and 2) Distress felt by the participants and their experiences as HIV-positive immigrants living in Spain. METHODS: Participants were recruited through a nongovernmental organization (NGO) during routine visits at the center. A total of 12 participants were interviewed to reach data saturation. Participants were HIV-positive immigrants living in Spain for 1 or more years, allowing for substantial experience with navigating the healthcare system. Thematic analysis was performed to identify common themes in participants’ experiences living as HIV-positive individuals in Spain and in accessing healthcare. RESULTS: Four primary themes were identified. The primary systemic barrier to accessing health care encountered by participants was the inability to fulfill the requirement of having proof of registration in an Autonomous Community for the required time period, thus not being able to apply for a public health insurance card and utilize free care services. Participants identified a positive impact of third party (NGO, social worker, friend/family member) guidance on their experience of applying for a public health insurance card. Participants expressed experiencing emotional or physical (eg, side effects of medication) distress in adapting to life as HIV-positive individuals. Participants also identified experiencing discrimination while living as HIV-positive immigrants in Spain. CONCLUSIONS: HIV-positive immigrants are underserved in Spain. They encounter systemic barriers while accessing healthcare services, and experience fear and/or discrimination. The study underscores the role of NGOs in helping HIV-positive immigrants navigate the healthcare system. More research is needed on comprehensive approaches to address healthcare needs of HIV-positive immigrants in Spain.
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spelling pubmed-78937232021-02-22 A qualitative study on mixed experiences of discrimination and healthcare access among HIV-positive immigrants in Spain Gogishvili, Megi Flórez, Karen R. Costa, Sergio A. Huang, Terry T.-K. BMC Public Health Research Article BACKGROUND: Immigrants are disproportionally impacted by HIV infection in Europe and in Spain. Immigrants are also identified as a vulnerable population during economic crises. Various socioeconomic barriers hinder HIV-positive immigrants from accessing healthcare services in the host country. As a result of the 2008 financial crisis, Spain has implemented multiple austerity measures, one of which was the enactments of Royal Decree Law (RDL) 16/2012 and Royal Decree (RD) 1192/2012 which abolished universal healthcare coverage. In this context, this study examined: 1) Participants’ mixed experiences in accessing health care after the enactment of 2012 RDL and RD, and 2) Distress felt by the participants and their experiences as HIV-positive immigrants living in Spain. METHODS: Participants were recruited through a nongovernmental organization (NGO) during routine visits at the center. A total of 12 participants were interviewed to reach data saturation. Participants were HIV-positive immigrants living in Spain for 1 or more years, allowing for substantial experience with navigating the healthcare system. Thematic analysis was performed to identify common themes in participants’ experiences living as HIV-positive individuals in Spain and in accessing healthcare. RESULTS: Four primary themes were identified. The primary systemic barrier to accessing health care encountered by participants was the inability to fulfill the requirement of having proof of registration in an Autonomous Community for the required time period, thus not being able to apply for a public health insurance card and utilize free care services. Participants identified a positive impact of third party (NGO, social worker, friend/family member) guidance on their experience of applying for a public health insurance card. Participants expressed experiencing emotional or physical (eg, side effects of medication) distress in adapting to life as HIV-positive individuals. Participants also identified experiencing discrimination while living as HIV-positive immigrants in Spain. CONCLUSIONS: HIV-positive immigrants are underserved in Spain. They encounter systemic barriers while accessing healthcare services, and experience fear and/or discrimination. The study underscores the role of NGOs in helping HIV-positive immigrants navigate the healthcare system. More research is needed on comprehensive approaches to address healthcare needs of HIV-positive immigrants in Spain. BioMed Central 2021-02-19 /pmc/articles/PMC7893723/ /pubmed/33607960 http://dx.doi.org/10.1186/s12889-021-10388-6 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Gogishvili, Megi
Flórez, Karen R.
Costa, Sergio A.
Huang, Terry T.-K.
A qualitative study on mixed experiences of discrimination and healthcare access among HIV-positive immigrants in Spain
title A qualitative study on mixed experiences of discrimination and healthcare access among HIV-positive immigrants in Spain
title_full A qualitative study on mixed experiences of discrimination and healthcare access among HIV-positive immigrants in Spain
title_fullStr A qualitative study on mixed experiences of discrimination and healthcare access among HIV-positive immigrants in Spain
title_full_unstemmed A qualitative study on mixed experiences of discrimination and healthcare access among HIV-positive immigrants in Spain
title_short A qualitative study on mixed experiences of discrimination and healthcare access among HIV-positive immigrants in Spain
title_sort qualitative study on mixed experiences of discrimination and healthcare access among hiv-positive immigrants in spain
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7893723/
https://www.ncbi.nlm.nih.gov/pubmed/33607960
http://dx.doi.org/10.1186/s12889-021-10388-6
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