Happy Friday World-
So as you guys may or may not know, I am a Community Wellness Navigator for a local organization here in Chicago. My goal is to get people who may have barriers and challenges access to PrEP, Medical Services, and other supportive services. But recently I got an inquiry from someone outside of Chicago who is looking to access PrEP in a medium-sized city located in the heart of the deep south.
So I figured from my experiences working in HIV prevention in S. Florida that “Hey, this should be a breeze and we can get things rolling pretty smoothly!” Well I was very wrong, so wrong that I even became frustrated myself at the system (
As if I wasn’t already.) and the lack of PrEP friendly providers, or even the amount of providers who knew what PrEP was but refused to prescribe it. What I have noticed is that differences in access to PrEP across different populations is the main reason for existing disparities in HIV. These differences occur for several reasons and some of the main factors that contribute to the problem in the United States are described below.
- Lack of health insurance – Several racial, ethnic, socioeconomic and other minority groups lack adequate health insurance compared with the majority population. These individuals are more likely to delay healthcare and to go without the necessary healthcare or medication they should have been prescribed.
- Lack of financial resources – Lack of available finance is a barrier to PrEP for many Americans but access to PrEP is reduced most among minority populations. Racial and ethnic minorities are often given a health insurance plan that limits the amount of services available to them as well as the number of providers they can use.
- Irregular source of care – Compared to white individuals, ethnic or racial minorities are less likely to be able to visit the same doctor on a regular basis and tend to rely more on clinics and emergency rooms. Without a stable provider people have more difficulty obtaining their prescriptions and attending necessary appointments.
- Legal obstacles – Low-income immigrant groups are more likely to experience legal barriers. For example, insurance coverage through Medicaid is not available to immigrants who have been resident in the U.S for less than five years.
- Structural barriers – Examples of structural barriers include lack of transport to providers, inability to obtain convenient appointment times and lengthy waiting room times. All of these factors reduce the likelihood of a person successfully making and keeping their PrEP regiment.
- Lack of PrEP providers – In areas where minority populations are concentrated such as inner cities and rural areas, the number of LGBT/PrEP practitioners and facilities is often inadequate.
- Language barriers – Poor English language skills can make it difficult for people to understand basic information about HIV or when they should get tested.
- Age – Older patients are often living on a fixed income and cannot afford to pay for their PrEP. Older people are also more likely to experience transport problems or suffer from a lack of mobility, factors that can impact on their access to PrEP. With 15% of the older adults in the U.S not having access to the internet, these individuals are also less likely to benefit form the valuable PrEP information that can now be found on the internet.
So if you are having trouble accessing PrEP in your area, you are not alone! But be assured you have a team of advocates, providers, and community members who are working hard to ensure you have access to PrEP in your area!
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