2023-09-28 14:46:10 +00:00
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abstract: 'Global and national HIV/AIDS policies utilize the care cascade to
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emphasize the importance of continued engagement in HIV services from
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diagnosis to viral suppression. Several studies have documented barriers
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that men experience in accessing services at specific stages of care,
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but few have analyzed how these barriers operate along the care cascade.
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Brazil offers a unique setting for analyzing barriers to HIV care
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because it is a middle-income country with a large HIV epidemic and
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free, universal access to HIV/AIDS services. Semi-structured interviews
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were conducted in 2011 with HIV-infected men (n=25) receiving care at
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the only HIV/AIDS state reference center in Salvador, Brazil, the third
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largest city in the country. Interviews were transcribed and coded for
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analysis. Researchers identified barriers to services along the care
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cascade: health service-related obstacles (poor-quality care, lengthy
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wait times, and drug supply problems); psychosocial and emotional
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challenges (fear of disclosure and difficulty accepting HIV diagnosis);
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indirect costs (transportation and absenteeism at work or school); low
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perceived risk of HIV; and toxicity and complexity of antiretroviral
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drug (ARV) regimens. The stages of the care cascade interrupted by each
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barrier were also identified. Most barriers affected multiple, and often
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all, stages of care, while toxicity and complexity of ARV regimens was
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only present at a single care stage. Efforts to eliminate more prevalent
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barriers have the potential to improve care continuity at multiple
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stages. Going forward, assessing the relative impact of barriers along
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one''s entire care trajectory can help tailor improvements in service
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provision, facilitate achievement of viral suppression, and improve
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access to life-saving testing, treatment, and care.'
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affiliation: 'Hoffmann, M (Corresponding Author), Brown Univ, Sch Publ Hlth, 121 South
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Main St,Suite 810, Providence, RI 02912 USA.
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Hoffmann, Michael; Batson, Ashley; Nunn, Amy, Brown Univ, Sch Publ Hlth, Providence,
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RI 02912 USA.
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Hoffmann, Michael; Batson, Ashley; Nunn, Amy, Miriam Hosp, Providence, RI 02912
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USA.
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MacCarthy, Sarah, RAND Corp, Santa Monica, CA 90407 USA.
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Crawford-Roberts, Ann, Icahn Sch Med Mt Sinai, New York, NY 10029 USA.
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Rasanathan, Jennifer, Montefiore Med Ctr, Dept Family \& Social Med, Bronx, NY 10467
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USA.
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Silva, Luis Augusto; Dourado, Ines, Univ Fed Bahia, Inst Collect Hlth, Salvador,
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BA, Brazil.'
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author: Hoffmann, Michael and MacCarthy, Sarah and Batson, Ashley and Crawford-Roberts,
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Ann and Rasanathan, Jennifer and Nunn, Amy and Silva, Luis Augusto and Dourado,
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Ines
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author-email: michael.tg.hoffmann@gmail.com
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author_list:
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- family: Hoffmann
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given: Michael
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- family: MacCarthy
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given: Sarah
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- family: Batson
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given: Ashley
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- family: Crawford-Roberts
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given: Ann
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- family: Rasanathan
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given: Jennifer
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- family: Nunn
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given: Amy
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- family: Silva
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given: Luis Augusto
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- family: Dourado
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given: Ines
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da: '2023-09-28'
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doi: 10.1080/09540121.2015.1062462
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eissn: 1360-0451
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files: []
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issn: 0954-0121
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journal: AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV
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keywords: HIV; AIDS; care cascade; barriers; men; delay; Brazil
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keywords-plus: 'ANTIRETROVIRAL THERAPY; DIAGNOSIS; AIDS; PREDICTORS; PREVENTION;
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SPECTRUM; COHORT; ADULTS; SEX; MSM'
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language: English
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month: JAN 2
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number: '1'
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number-of-cited-references: '36'
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orcid-numbers: 'Dourado, Ines/0000-0003-1675-2146
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Crawford-Roberts, Ann/0000-0002-0630-4430'
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pages: 57-62
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papis_id: 165f732aa6f5e1b5ba728e8a2b6e476e
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ref: Hoffmann2016barrierscare
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researcherid-numbers: 'Dourado, Ines/Q-6535-2016
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'
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times-cited: '15'
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title: Barriers along the care cascade of HIV-infected men in a large urban center
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of Brazil
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000368505200007
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usage-count-last-180-days: '0'
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usage-count-since-2013: '6'
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volume: '28'
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web-of-science-categories: 'Health Policy \& Services; Public, Environmental \& Occupational
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Health;
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Psychology, Multidisciplinary; Respiratory System; Social Sciences,
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Biomedical'
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year: '2016'
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