Limited information is available about factors that aff ect care engagement among African American older people living with HIV (OPLWH), despite the fact that this is the racial/ ethnic group most disproportionally living with HIV/ AIDS in the United States. Th e present mixed methods study examined the experiences of stress, HIV-related stigma, and engagement in care in a sample of 35 African American OPLWH. Quantitative methods measured global stress, HIV-stigma, and engagement in care, while in-depth qualitative interviews captured the lived experiences of HIV care engagement. Engagement in care was moderately correlated with overall stigma (r = -0.33, p = .05) and perceived stress (r = -0.42, p = .01). Qualitative interviews revealed that stigma was not the most signifi cant stressor in the elders' lives, but instead a present and underlying force that was overshadowed by everyday life stressors that aff ected care engagement. Recommendations include that a retention specialist work alongside health care providers to increase engagement.

Abstract:The objective of this study was to explore health-seeking behaviors and barriers faced in accessing care among homeless youth living in Ho Chi Minh City, Vietnam. Twelve in-depth interviews were conducted with homeless youth aged 18 to 25. Participants were identified using purposive sampling. Data were analyzed using constructivist grounded theory techniques. Interviews with youth revealed that while living on the streets, they had to balance their need for security with attending to their daily survival needs, which led to a disconnection from thinking about their health. When faced with a major health issue, youth turned to their informal networks of support instead of seeking immediate medical care. To manage their basic health needs, youth obtained medicine and health advice from local pharmacies and sought advice from social workers. Homeless youth interviewed in this study relied on an informal network of peers, social workers, and pharmacies when engaging with the health care system. They also faced several barriers to accessing health services, many of which are tied specifically to policies that make homelessness discriminated against in Vietnam. Within Vietnam's unique political and social context, there is a need for increased collaboration between service providers such as health clinics, local pharmacies, and social workers to provide appropriate health services to this vulnerable population.

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