Study finds health care barriers for most pet owners with HIV

Reviewed by Megan Craig, M.Sc.Nov 1 2023

People living with HIV may face hard choices when balancing their own health needs with caring for a pet, a study led by a University of Florida College of Public Health and Health Professions researcher finds.

For the study, which appears in the journal PLOS ONE, 36% of people with HIV who own pets reported delaying health care, not seeking it or said they expect to do so in the future. Financial and other resource concerns, including not having access to pet sitting or boarding services, are among the leading factors that may contribute to health care barriers among pet owners with HIV.

Pets can provide important benefits for people with HIV, said study lead author Jennifer Applebaum, Ph.D., an assistant professor in the department of environmental and global health.

Pets are thought to provide nonjudgmental emotional and social support for people with HIV, who may feel stigmatized or rejected by some of the people in their lives. Previous research has also found that pets can provide a meaningful activity and routine that may help with medication adherence. For example, you feed your dog and you take your meds at the same time."

Jennifer Applebaum, Ph.D., Lead Author

Antiretroviral medications used to treat HIV have dramatically improved HIV prognosis and people with the disease are living longer, healthier lives. The treatment regimen, however, can be time-consuming; people with HIV have frequent medical appointments and are screened for viral load and white blood cell counts every few months. As people with HIV age, they are more likely to develop other health conditions caused by the disease and long-term medication use, which may require treatment by other specialists in heart, brain and kidney health. It can all add up to a significant burden of time and out-of-pocket costs for a group that is disproportionately low-income.

Issues related to pet ownership, financial concerns and housing access are closely linked and are common among people living with HIV, said study co-author Maya Widmeyer, M.D., special projects director for Unconditional Love Inc., a Melbourne, Florida-based agency providing essential services and support for people with HIV.

"I have come across quite a few cases where barriers to housing and finance were a result of pet ownership," Widmeyer said. "There have been cases of people struggling to find housing that allows pets and eventually owners need to establish living quarters far from the clinic, which creates issues of transportation or leaving pets too long at home in order to adhere to HIV appointments."

Applebaum's work in health care barriers for pet owners began during the COVID-19 pandemic when she led a survey of more than 1,300 pet owners and found that 10% reported they would delay or avoid COVID-19 testing or treatment out of concern that their pets would not have proper care in their absence. The new UF Health study demonstrates the issue is more prevalent for pet owners with HIV, but pet-related health care barriers are likely common among people with other chronic health conditions that require frequent health care appointments, such as cancer or diabetes, or may lead to extended stays in care facilities, such as substance use disorders, Applebaum said.

The study findings point to a need for systemic interventions that provide better support for pet owners with chronic conditions, Applebaum said. These may include health care providers allowing people to bring their pets to appointments; community health clinic partnerships with veterinary practices to offer low-cost or free veterinary care and boarding; pet food banks; and free health clinics offering screening and vaccinations for both humans and pets.

"We need more systemic and community-level interventions that can support people who are facing issues with their health and their pets," Applebaum said. "We know pets are really important for owners' emotional and social support and may even bolster people's health. The solution is not to take away people's pets."

The team's study is based on responses from more than 200 pet owners who are members of the Florida Cohort, a group of people with HIV across the state of Florida who are helping researchers at the Southern HIV and Alcohol Research Consortium identify barriers to treatment and improve health outcomes for Floridians with HIV.

In addition to Applebaum and Widmeyer, study authors include Shelby McDonald, Ph.D., director of community research and evaluation at the Denver Zoological Foundation; Humberto Fabelo, Ph.D., an associate professor of social work at Virginia Commonwealth University; and Robert Cook, M.D., M.P.H., a UF professor of epidemiology and director of the Southern HIV and Alcohol Research Consortium.