Background: This study aimed to describe the unique structural barriers faced by Latina women in rural areas of Virginia as they attempt to access the health care system, and, once they have gained access, to identify barriers to intimate partner violence (IPV) disclosure.

Methods: Semi-structured in-depth individual interviews with first-generation Latina immigrants were conducted after initial purposeful convenience sampling and concomitant snowball recruiting. A thematic content analysis using a phenomenological approach was employed to interpret participants' experiences. Initial findings were validated through additional interviews.

Results: The overarching theme expressed by these women was their search for dignity. Emergent sub-themes related to health care barriers and reluctance to disclose IPV included: no confianza, having a voice, being marginalized, and navigating a dysfunctional system.

Discussion: Initial encounters with the health care system that led participants to feel disrespected interfered with care access and a sense of safety in answering intimate questions, especially concerning safety. The dysfunctional and disjointed health care system also creates unintended barriers to access and continuity of care.

Conclusion and Recommendations: The experiences of barriers encountered by the women in our study suggests that reported discrepancies in IPV disclosure rates may be related to their level of perceived safety when being screened. In an effort to provide more accessible, safe and relevant care, an equity-informed approach such as trauma and violence informed care should be implemented within health care organizations to help provide more satisfying, safe and comprehensive care to immigrant populations.



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