PRP035: Barriers and Facilitators Associated with the HIV Care Cascade for Migrants in OECD Nations: A Mixed Studies Review Protocol
Anish Arora, MSc; Amelie Quesnel-Vallee; David Lessard, PhD; Kedar K.V. Mate, PhD, MSc; Adriana Rodriguez Cruz, PhD, BSc; ASAP Migrant Advisory Committee; Nadine Kronfli; Kim Engler, PhD; Isabelle Vedel, MD, PhD; Bertrand Lebouché, MD, PhD
Context: In 2019, the United Nations estimated the number of international migrants to be 272 million globally, a number that has increased by 51 million since 2010. Approximately 50% of all international migrants migrate to only 10 countries, 8 of which are members of the Organization for Economic Co-operation and Development (OECD). Migrants in OECD countries are often at higher risk for acquiring human immunodeficiency virus (HIV) and have higher frequency of delayed HIV diagnosis. Barriers and facilitators that various migrant populations living in OECD countries face in relation to HIV care are insufficiently understood. The five-step HIV Care Cascade Continuum (HCCC) is an effective model to identify gaps, barriers, and facilitators associated with HIV care. Objective: To generate a comprehensive, multilevel, understanding of barriers and facilitators associated with the five-step HCCC model in OECD countries by migration status. Study Design & Analysis: Systematic mixed studies review using a data-based convergent design. Quantitative data will be transformed to qualitative data for analysis. Qualitative thematic analysis and visualization methods will be utilized to synthesize the data. The Mixed Methods Appraisal Tool will be used for quality assessment of all retained articles. Four migrant patient partners from the McGill University Health Centre will be consulted throughout the duration of this study and be engaged in analysis, interpretation, and knowledge dissemination. Dataset: Medline, Embase, Scopus, CINAHL, and the Cochrane Library. Population Studied: International migrants include people engaging in all forms of movement across countries, temporarily or permanently, and for a variety of reasons. All international migrants that migrate to an OECD country will be included in this study. Outcome Measures: Barriers and/or facilitators collected from the results section of retained studies. Anticipated Results/Outcomes: Barriers and facilitators will be grouped according to two frameworks: (1) the HCCC model, which consists of diagnosis, linkage to care, treatment provision, treatment uptake, and viral suppression; and (2) a social-ecological model which frames barriers and facilitators to care under different levels including individual, community, organizational, and policy issues. Results of this study will be used to identify gaps in HIV care by migrant status in order to better identify priorities and orient future interventions.