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Provider-Initiated HIV Testing for Migrants in Spain: A Qualitative Study with Health Care Workers and Foreign-Born Sexual Minorities

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INTRODUCTION: Provider-initiated HIV testing (PITC) is
                increasingly adopted in Europe. The success of the approach at
                identifying new HIV cases relies on its effectiveness at testing
                individuals most at risk. However, its suitability to reach
                populations facing overlapping vulnerabilities is under
                researched. This qualitative study examined HIV testing
                experiences and perceptions amongst Latin-American migrant men
                who have sex with men and transgender females in Spain, as well
                as health professionals' experiences offering HIV tests to
                migrants in Barcelona and Madrid. METHODS: We conducted 32
                in-depth interviews and 8 discussion groups with 38
                Latin-American migrants and 21 health professionals. We imported
                verbatim transcripts and detailed field work notes into the
                qualitative software package Nvivo-10 and applied to all data a
                coding framework to examine systematically different HIV testing
                dimensions and modalities. The dimensions analysed were based on
                the World Health Organization "5 Cs" principles: Consent,
                Counselling, Connection to treatment, Correctness of results and
                Confidentiality. RESULTS: Health professionals reported that
                PITC was conceptually acceptable for them, although their
                perceived inability to adequately communicate HIV+ results and
                resulting bottle necks in the flow of care were recurrent
                concerns. Endorsement and adherence to the principles
                underpinning the rights-based response to HIV varied widely
                across health settings. The offer of an HIV test during routine
                consultations was generally appreciated by users as a way of
                avoiding the embarrassment of asking for it. Several
                participants deemed compulsory testing as acceptable on public
                health grounds. In spite of-and sometimes because of-partial
                endorsement of rights-based approaches, PITC was acceptable in a
                population with high levels of internalised stigma. CONCLUSION:
                PITC is a promising approach to reach sexual minority migrants
                who hold high levels of internalised stigma but explicit extra
                efforts are needed to safeguard the rights of the most
                vulnerable.

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Reproducció del document publicat a:
                http://dx.doi.org/10.1371/journal.pone.0150223

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Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Provider-Initiated HIV Testing for Migrants in Spain: A Qualitative Study with Health Care Workers and Foreign-Born Sexual Minorities