Exploring barriers to the HIV care continuum among people living with HIV in South Korea: a cross-sectional descriptive study

Abstract

Despite the importance of care continuum in managing chronic diseases, people living with HIV (PLWH) face multiple challenges. This study explored the multifaceted barriers to the HIV care continuum perceived by PLWH and assessed differences based on individual characteristics. A cross-sectional online survey was conducted with 243 PLWH from five hospital outpatient clinics. Factor analysis identified 26 items clustered into five subdomains of barriers to the HIV care continuum: "unfriendly healthcare service", "life and environmental factors distracting from treatment", "internal and social stigma", "difficulties in adhering to medication", and "denial and fear of diagnosis". Descriptive analysis showed that total barrier scores were significantly higher among individuals with college-level education or higher, unemployment, single marital status, non-receipt of National Medical Aid, and high self-efficacy in managing their healthcare (all p < .05). Regarding barrier subdomains, internal and social stigma was more prominent in the early stage of HIV diagnosis, while unfriendly healthcare service and difficulties in medication adherence were greater in the later stage. The identified barriers spanned diagnosis, treatment, healthcare services, and stigma, and vary by individual characteristics and stage of diagnosis. These findings emphasize the need for tailored, stage-specific interventions to enhance continuity of HIV care.