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  11. Understanding Care Experiences Amongst Immigrant And Refugee Clients In A Ryan-white Funded Hiv Clinic

Understanding care experiences amongst immigrant and refugee clients in a Ryan-White funded HIV clinic

Sirey Zhang1,2, Peggy-Ita Obeng-Nyarkoh3, Antonia Altomare3,4

  • 1The Geisel School of Medicine at Dartmouth, Hanover, NH, USA. sirey.zhang@hsc.utah.edu.

Communications Medicine
|June 10, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

This study explored how cultural, social, and structural barriers affect HIV care for immigrants and refugees. Mitigating power dynamics and adopting multidimensional cultural competence improves health equity and well-being.

Area of Science:

  • Public Health
  • Sociology
  • Medical Anthropology

Background:

  • Immigrants and refugees with HIV face unique challenges in high-income countries.
  • Cultural, social, and structural barriers impede access and adherence to HIV care.
  • This project aimed to improve care systems by understanding client and provider experiences.

Purpose of the Study:

  • To explore the experiences of immigrant and refugee clients and care providers within HIV clinics.
  • To identify barriers and facilitators to accessing and adhering to HIV care.
  • To inform strategies for improving culturally competent care for vulnerable populations.

Main Methods:

  • Focused ethnography utilizing participant observation and standardized interviews.
  • Involved 18 clients and 4 clinic team members across three HIV clinics.

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  • Data analysis involved coding, categorization, and theme development, with interpretation services and compensation provided.

    • Main Results:

    • Mitigating power dynamics between clients and clinicians, and among care team members, enhances the care experience.
    • Clients fear stigma within their communities and face healthcare access challenges due to immigration status.
    • Clients desire more clinic engagement in family, community communication, and advocacy.

    Conclusions:

    • Culturally competent care must be multidimensional, considering interpersonal interactions, hybridized identities, diasporic experiences, and structural inequities.
    • Reframing cultural competence and addressing structural vulnerabilities can transform healthcare interactions.
    • Implementing equity-oriented strategies enhances the well-being of immigrant and refugee populations with HIV.