Understanding why racial/ethnic inequities along the HIV care continuum persist in the United States: a qualitative exploration of systemic barriers from the perspectives of African American/Black and Latino persons living with HIV

Table 3 Inter-related recommendations for policy, supports, and clinical practice based on the present study

Address fundamental causes
Poverty	Implement anti-poverty initiatives tailored to the needs of this population
Systemic racism	Address systemic racism in order to end the HIV epidemic
Improve aspects of benefits & entitlements
Social safety net programs	Improve and expand programs for housing, income maintenance, and food security, as well as medical insurance and drug assistance programs in some geographical locations
Housing	The match between PLWH’s needs and the type and quality of housing matters. Place PLWH in private (non-congregate) settings as much as possible, as appropriate
Housing	Increase income maintenance levels to support the stability of housing placements
Change aspects of treatment settings
Structural/cultural competency	Improve structural and cultural competency in health care settings to enhance Black and Latino PLWH’s engagement in and satisfaction with care, trust in providers, self-disclosure, and health outcomes
Substance use	Provide autonomy-supportive, dignity-enhancing, and harm reduction approaches in HIV care settings to increase PLWH’s engagement, satisfaction, and treatment options
Substance use	Improve timely and easy access to substance use services, both in-person and virtual services
Eliminate incentives to divert HIV medication
Drug diversion	Authorities can locate pharmacies engaging in illegal drug diversion and compel them to cease
Drug diversion	Increase PLWH’s income maintenance levels to reduce the need to divert HIV medications

ISSN: 1475-9276