Negotiating access and culture: organizational responses to the healthcare needs of refugees and asylum seekers living with HIV in the UK

This paper examines possible explanations for difficulties that refugees and asylum seekers living with HIV have with accessing healthcare. It argues that complexity must be recognized as a central and defining feature of access to healthcare for this marginalized group, thus requiring a multi-disciplinary view of both the problem and organizational responses to it. The paper begins by considering the prominent notion of cultural competency and the imperative to improve cross-cultural understanding in doctor-patient interactions. It goes on to illustrate the complexity of factors that influence healthcare decisions and opportunities for refugees and asylum seekers living with HIV. Finally, it reviews the cultural, social, legal, institutional and structural barriers that jointly prevent effective and successful healthcare utilization.