TY - JOUR
T1 - Health outcomes and healthcare utilization of Native Hawaiians and other Pacific Islanders living with HIV in Hawai‘i
T2 - A mixed-methods study
AU - Pacheco, Misty
AU - Agner, Joy Lynn
AU - Myers, Tara K.
AU - Franco, Jeena
AU - Barile, John P.
AU - Kaholokula, Joseph Keawe‘aimoku
AU - Baldwin, Julie A.
N1 - Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022
Y1 - 2022
N2 - Objectives: Past research shows mixed outcomes in terms of HIV-related disparities among Native Hawaiians and Pacific Islanders (NHOPI). This study investigates HIV-related disparities among NHOPI living with HIV in Hawai‘i. Design: An explanatory sequential design was utilized. The quantitative portion analyzed survey data from a statewide Ryan White Needs Assessment (N = 398) to examine the differences in viral suppression and satisfaction with care between NHOPI and other ethnic groups. Utilizing the behavioral model for vulnerable populations (BMVP), semi-structured interviews (N = 16) were conducted next to explain what factors play a role in satisfaction with care and viral suppression when it comes to NHOPI living with HIV in Hawai‘i. Results: Among the 398 participants 13% were NHOPI. NHOPI were more likely to have a viral load of ≥10,000 copies/mL compared to those who didn’t identify as NHOPI. However, there were no significant differences for other viral load levels (20–199 or 200–9999), and only 20 participants (5.2%) had a viral load of 10,000 copies/mL or more. No significant ethnic differences were found in satisfaction with medical care. In the qualitative phase, factors from all domains of the BMVP were represented within the four themes identified: (1) Care coordination is essential- with AIDs service organizations taking the lead; (2) HIV care, as well as overall health, is defined by the effectiveness of medication; (3) Initial diagnosis is a critical moment for intervention; and (4) Aspects of culture are intangible. Conclusion: Among NHOPI in Hawai‘i who are engaged in case management, there appears to be no substantial disparities in either viral load or satisfaction with care compared to other ethnic groups. Despite this, qualitative findings provide insights on how ethnicity and culture may still be playing a role. Addressing all domains of the BMVP is crucial to addressing this.
AB - Objectives: Past research shows mixed outcomes in terms of HIV-related disparities among Native Hawaiians and Pacific Islanders (NHOPI). This study investigates HIV-related disparities among NHOPI living with HIV in Hawai‘i. Design: An explanatory sequential design was utilized. The quantitative portion analyzed survey data from a statewide Ryan White Needs Assessment (N = 398) to examine the differences in viral suppression and satisfaction with care between NHOPI and other ethnic groups. Utilizing the behavioral model for vulnerable populations (BMVP), semi-structured interviews (N = 16) were conducted next to explain what factors play a role in satisfaction with care and viral suppression when it comes to NHOPI living with HIV in Hawai‘i. Results: Among the 398 participants 13% were NHOPI. NHOPI were more likely to have a viral load of ≥10,000 copies/mL compared to those who didn’t identify as NHOPI. However, there were no significant differences for other viral load levels (20–199 or 200–9999), and only 20 participants (5.2%) had a viral load of 10,000 copies/mL or more. No significant ethnic differences were found in satisfaction with medical care. In the qualitative phase, factors from all domains of the BMVP were represented within the four themes identified: (1) Care coordination is essential- with AIDs service organizations taking the lead; (2) HIV care, as well as overall health, is defined by the effectiveness of medication; (3) Initial diagnosis is a critical moment for intervention; and (4) Aspects of culture are intangible. Conclusion: Among NHOPI in Hawai‘i who are engaged in case management, there appears to be no substantial disparities in either viral load or satisfaction with care compared to other ethnic groups. Despite this, qualitative findings provide insights on how ethnicity and culture may still be playing a role. Addressing all domains of the BMVP is crucial to addressing this.
KW - AIDS
KW - HIV
KW - HIV care continuum
KW - Native Hawaiian
KW - Pacific Islander
KW - culturally-relevant care
KW - culture and healthcare
KW - healthcare utilization
KW - viral suppression
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UR - http://www.scopus.com/inward/citedby.url?scp=85117203837&partnerID=8YFLogxK
U2 - 10.1080/13557858.2021.1990219
DO - 10.1080/13557858.2021.1990219
M3 - Article
C2 - 34647505
AN - SCOPUS:85117203837
SN - 1355-7858
VL - 27
SP - 1841
EP - 1858
JO - Ethnicity and Health
JF - Ethnicity and Health
IS - 8
ER -