Health System Experiences and Care Engagement in Latine Patients With Hidradenitis Suppurativa.

Abstract

Latine patients with hidradenitis suppurativa (HS) are reported to experience more severe disease and longer delays to diagnosis compared with White patients with HS. To assess the implications of health care system factors in HS care experiences for Latine patients. From June 2024 through March 2025, this qualitative study recruited English- and Spanish-language preferring Latine adults diagnosed with HS from dermatology clinics at 2 academic medical centers and 2 county hospitals in California. Deidentified audio recordings were transcribed and translated from semistructured interviews conducted by a bilingual Latine interviewer. After transcripts were coded, a thematic analysis was conducted to develop themes that captured the range of participants' experiences, attitudes, behaviors, and beliefs related to receiving health care for HS and implementing HS care plans throughout their HS care journey, including the time before they received care from their current dermatologist. Among the 24 Latine patients included in the analysis, the median (IQR) age was 37.5 (32.75-44.25) years, 17 (71%) were female, 11 (46%) preferred Spanish, and 19 (79%) had Hurley stage 2 or 3 disease. Three themes were developed. First, unaddressed wound care and pain management burdens patients with self-directed care, with 2 subthemes: (1) insufficient guidance for patients' wound care and pain management and (2) self-directed care in response to limited health care system support for pain management and wound care creates personal burden. Second, perceived discrimination during dermatology visits leads to avoidance of care. Third, patient-centered care remains a challenge with phone or video interpreter-mediated communication. In this study, many Latine participants with HS experienced unaddressed wound care and pain management needs, perceived discrimination, and challenges with interpreter-mediated communication during care with a dermatologist. Interventions are needed to prioritize wound care and pain management in multidisciplinary care plans and optimize patient-centered HS care.