Connecting the Dots: Provider Characteristics and Perceptions of HIV Care Barriers in Virginia
Abstract
Introduction: Social Determinants of Health (SDOH) significantly impact HIV care outcomes, yet their integration into clinical practice remains challenging. This study investigated the perceptions, attitudes, and practices of HIV healthcare providers regarding SDOH in Virginia, addressing a critical gap in understanding the barriers to comprehensive HIV care.
Methods: A cross-sectional, web-based survey was conducted among 124 HIV healthcare providers in Virginia (response rate: 32.8%). The survey instrument, developed through expert consultation and pilot testing (Cronbach's α = 0.86), assessed providers' SDOH-related perceptions and practices. Data were analyzed using descriptive statistics, bivariate analyses, and multiple linear regression.
Results: While providers widely acknowledged SDOH importance (M = 3.93, SD = 1.19 on a 5-point scale), significant discrepancies emerged between recognition and action. Housing insecurity (24.9%), financial instability (18.7%), and food insecurity (15.0%) were identified as primary SDOH barriers. Provider characteristics, including race, job role, and geographic location, significantly influenced SDOH perceptions (p < 0.05). Key barriers to SDOH integration included time constraints, lack of standardized screening tools, and limited reimbursement for SDOH-related activities.
Conclusion: This study reveals a complex landscape of provider perspectives on SDOH in HIV care, highlighting a critical gap between awareness and practice. Findings underscore the need for tailored educational interventions, standardized SDOH screening tools, and policy changes to facilitate SDOH integration in HIV care settings. By elucidating provider-level barriers, this research informs targeted strategies to enhance SDOH consideration in clinical practice, potentially improving HIV care outcomes and reducing health disparities.