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.