The purpose of this study is to understand the determinants of entry and engagement in HIV primary care services for Blacks and Hispanics living in single room occupancy (SRO) hotels in Bronx and Manhattan, NY. More specifically, the goal is to examine baseline cultural characteristics of the patient, health-related characteristics of the patient, the patient-provider relationship, and the impact of community outreach on engagement in health care. The objectives are to: examine the association between trust, relationship with provider, social support, and health beliefs with engagement in HIV primary care services; examine the association between health-related characteristics and engagement in HIV primary care services; examine the association of perceived cultural concordance between provider and patient with engagement in HIV primary care services; and, explore the relationship between community outreach and entry into HIV primary care services.

We will be recruiting a convenience sample of 500 Black or Hispanic HIV-infected adults living in 14 SRO hotels (transitional emergency housing) in the Bronx and Manhattan, NY. We will be conducting interviews through auditory computer-assisted self-interviewing (A-CASI) technology, using standardized research instruments administered in English or Spanish. We will also be reviewing medical charts and records from Citiwide and Montefiore appointment databases.

Understanding barriers to engagement in HIV primary care will lead to development of culturally relevant interventions to assist Black and Hispanic persons in entering and engaging in HIV treatment. Implementation of these interventions will ultimately help reduce disparities in HIV-related healthcare, as well as reduce HIV morbidity and mortality in Black and Hispanic populations.