Real-world experience of barriers to diagnosis, early detection and disease management among migrants living with HIV in Spain: a qualitative study

To describe the barriers and challenges in the medical care management of a group of migrants living with HIV who received medical assistance through the Spanish Public Health Care Services. A qualitative descriptive study was conducted. The inclusion criteria comprised patients with a confirmed serological diagnosis of HIV whose countries of origin were in Latin America, the Caribbean, Africa, or Eastern Europe. A total of 21 patients were selected through purposive sampling. Data collection involved in-depth interviews and researcher field notes. A thematic analysis was performed, and trustworthiness criteria were applied. Two themes were identified that illustrate the barriers to healthcare in migrants living with HIV: a) Personal beliefs and the social and family environment, participants often remain in contact with members of their culture and/or ethnic group of origin, and their environment can hinder help-seeking, treatment adherence, or open communication about their illness; b) The healthcare environment, where obstacles and challenges faced by participants are described in relation to the healthcare environment, the healthcare system, and healthcare providers. The results of this study provide a foundation for developing a roadmap of relevant patient-reported outcomes in HIV care. These insights can guide the implementation of improved healthcare strategies for migrants living with HIV. Personal beliefs and the family and social environment of migrants with HIV can create barriers to seeking care. Expectations about health care in the host country, along with administrative difficulties, can delay diagnosis and treatment. Limited coordination between primary care and hospitals, as well as lack of awareness of available resources, further delays access to timely care. Personal beliefs and the family and social environment of migrants with HIV can create barriers to seeking care. Expectations about health care in the host country, along with administrative difficulties, can delay diagnosis and ...