Lessons Learned in Reducing Barriers to Care: Reflections from the Community Perspective

SUMMARY Six projects targeting individuals traditionally under-served by the HIV care system performed a cross-cutting evaluation of their programs. Using qualitative and quantitative techniques, the programs showed that they had enrolled more than 1,400 individuals living with HIV. At intake, the clients cited numerous barriers they had previously encountered in approaching services. The clients had high levels of drug abuse, very few had earned income, and most were members of ethnic-racial minority groups. The strategies used by these projects for recruiting hard-to-reach, traditionally underserved individuals appear to be effective. Issues in designing and implementing projects in community-based organizations are discussed.