For People With HIV, Pets Can Be a Barrier to Healthcare

Source: Courtesy of Hal Herzog

Our love of pets runs deep. Take my friends Ron and Sue. They canceled a trip to Europe last summer because Ron did not want to leave their dog, Beaux.

But sacrificing a river cruise on the Rhine to stay with your dog is not the same as compromising your health because of the demands of pet ownership. For example, in a 2020 study, the University of Florida's Jennifer Applebaum and her colleagues found that 10 percent of American pet owners would consider not getting a COVID test because of concerns about their pet's welfare. As one woman wrote, "I delayed going to the hospital for COVID symptoms because I was worried no one would be there for my dog."

Applebaum and her colleagues Shelby McDonald, Humberto Fabelo, Maya Whidmeyer, and Robert Cook recently examined healthcare problems faced by pet owners with HIV. While it was once considered a death sentence, dozens of anti-HIV medications are now available.

Today, people with HIV can have normal life spans. However, the medical demands of HIV treatments are challenging. Some antiretroviral meds need to be taken daily, and people with HIV should have blood tests every three to six months.

Further, the estimated lifetime medical costs of HIV treatments range from $500,000 to $1 million. The challenges of living with HIV are compounded by the fact that, in the United States, people with HIV are more likely to be members of groups underserved by our healthcare system—poor, LGBTQ, or Black or Latino.

Some studies have reported that, among people with HIV, pet owners have better mental health. Researchers at the University of Chicago, for example, found that dog owners with HIV were three times less likely to suffer from depression than non-owners. And people with HIV consistently report their pets provide emotional support and unconditional love.

Yet, pet ownership can inhibit access to medical services. Applebaum's research team was interested in how companion animals can complicate healthcare options among people with HIV.

The Florida Cohort Study

The study was based on data collected as part of the Southern HIV and Alcohol Research Consortium's Florida Cohort, a longitudinal study of the impact of HIV among Floridians. The participants were 219 pet owners with HIV. They were, on average, 49 years old and had been diagnosed with HIV for 19 years.

Fifty-seven percent of them were male, 40 percent were female, and 3 percent were other genders. Seventy percent were dog owners, and 39 percent lived with cats.

In addition to basic demographic information, participants in the study completed a series of questions on aspects of pet ownership related to HIV. These included:

• A 12-item index of the various barriers in which pet-keeping influenced decisions to seek or miss healthcare services.
• A 12-item measure of how much comfort they received from their pets
• A 12-item measure of the individuals' perceived social support.

Pets as Healthcare Barriers

As reported in the journal PLOS One, the researchers found that a third of the participants had experienced or expected to experience pet-related impediments to their access to medical services. For example, 25 percent of them said they would delay seeking healthcare if it meant they could not take care of their pets. Six percent of the participants had been unable to receive health because they were concerned for their pets, and 4 percent indicated that the costs of pet ownership had affected their ability to pay for their medicines.

The number of pet-related healthcare barriers experienced or anticipated by the participants was affected by their incomes and social support. Individuals with HIV in the lowest income group and those with the least social support faced the most pet-related income barriers. And, as you might expect, participants who obtained more emotional comfort from their pets experienced more pet-related barriers to health care.

Black pet owners were more likely than White pet owners to think they would experience pet-related impediments to medical services in the future. Individuals who derived more comfort from their companion animals and those with lower support systems also anticipated more problems with access to healthcare. This was also true of participants who were taking antiretroviral medications.

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One of the study's authors was Maya Whidmeyer, the special projects director for Unconditional Love, Inc., a Brevard County, Florida, organization that provides support services for people with HIV. She told me that issues related to housing are the biggest barriers to adequate health care among the people she sees, and affordable housing can be limited when pets are involved. She added that, in her experience, the stigma of HIV often leads to isolation, and in these cases, pets are a particularly important source of comfort.

The Tip of the Iceberg?

While this study focused on people with HIV, the results may apply to other socially isolated groups. For example, a 2015 study found that 11 percent of homeless youths said having a pet made it harder for them to see a doctor. Applebaum believes that the barriers to health services among people with HIV may also apply to millions of pet owners who suffer from other chronic health problems.

The solution, she argues, is not to take away or prevent chronically ill people from having pets. Rather, our society should provide better support for ailing pet owners. This could include allowing them to bring their pets to medical appointments, establishing community health clinics that partner with low-cost or free veterinary services, or pet-boarding.

This sounds like a plan to me. But, clearly, more research on the impact of pets on access to healthcare in underserved communities is needed.