Post-immigration factors affecting retention in HIV care and viral suppression in Latin American and Caribbean immigrant populations in the United States: a systematic review

ABSTRACT

Objectives

To reduce disparities in HIV care outcomes among Latin American and Caribbean (LAC) immigrants living with HIV in the U.S., it is necessary to identify factors influencing HIV care in this population. A systematic review that provides a comprehensive understanding of factors influencing retention in HIV care and viral suppression among LAC immigrants living with HIV in the U.S. is lacking. This systematic review used the Immigrant Health Services Utilization theoretical framework to provide an understanding of these factors.

Design

We searched for peer-reviewed publications in MEDLINE, EMBASE, CINAHL, PsycINFO, and ASSIA, from January 1996 to June 2020.

Results

A total of 17 qualitative (n = 10) and quantitative (n = 7) studies were included in the review. The most commonly reported general and immigrant-specific factors appearing in studies were undocumented immigration status, HIV stigma, homophobia, cultural norms, values and beliefs, family and social support, language barriers, structure, complexity and quality of the U.S. healthcare delivery system, and patient-provider relationship.

Conclusion

These findings highlight the importance of considering immigrant-specific factors along with general factors to improve the provision of HIV care services and HIV care outcomes among LAC immigrant populations.

KEYWORDS:

• HIV
• retention in care
• viral suppression
• Latin America
• Caribbean
• immigrants

Acknowledgements

The authors would like to thank Barbara M. Sorondo, Health Sciences Librarian at the FIU Libraries, for her contribution in developing the search strategy.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was supported in part by the National Institute on Minority Health and Health Disparities of the National Institutes of Health (award numbers: U54MD012393, Florida International University Research Center in Minority Institutions, and K01MD013770) and National Institute on Drug Abuse (award number: T32DA023356). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.