# Understanding barriers to HIV care and treatment adherence in Guyana and the Caribbean: A mixed-methods analysis

## TL;DR

This study explores the main barriers to HIV care and treatment adherence in Guyana and the Caribbean, finding stigma, financial issues, and transportation challenges to be significant.

## Contribution

The study provides new insights into the socioeconomic and logistical barriers affecting HIV treatment adherence in the Caribbean region.

## Key findings

- Stigma (60%), financial constraints (55%), and transportation (45%) were the top barriers to HIV care.
- Peer counseling and follow-up support significantly improved re-engagement in care (P < 0.01).
- 15% of participants discontinued treatment due to side effects, stigma, or financial barriers.

## Abstract

•Stigma and access barriers dominate.•Socioeconomic disparities influence access.•Adherence and clinic engagement challenges.•Drivers of disengagement from care.•Effectiveness of support interventions.

Stigma and access barriers dominate.

Socioeconomic disparities influence access.

Adherence and clinic engagement challenges.

Drivers of disengagement from care.

Effectiveness of support interventions.

This study aimed to identify and analyze the primary barriers to HIV care and treatment adherence in Guyana and the Caribbean.

A cross-sectional mixed-methods design was employed, incorporating quantitative surveys and qualitative interviews with 200 HIV-positive individuals attending clinics in Guyana and the Caribbean. The data were analyzed using both descriptive and inferential statistics. Ethical approval was obtained.

Key findings revealed that stigma (60%), financial constraints (55%), and transportation issues (45%) were the most reported barriers. Stigma was particularly prevalent among unemployed participants (P <0.05), while transportation challenges were more significant in rural areas (P <0.01). Approximately 85% of participants reported adherence rates above 90%, but 15% had discontinued treatment due to side effects, stigma, or financial barriers. Follow-up support, such as peer counseling, significantly improved re-engagement in care (P <0.01).

The study highlights the multifaceted barriers to HIV care in Guyana and the Caribbean, emphasizing the urgent need for targeted interventions to reduce stigma, improve financial accessibility, and enhance follow-up services.