Nine Circles Community Health Centre

Abstract Background: Blood and oral fluid-based HIV self-tests are important for reaching the undiagnosed especially in key populations. The study objectives were to: (1) evaluate the oral fluid-based OraQuick® HIV Self-Test (HIV-ST) performance compared with laboratory reference testing; (2) document if intended users can correctly perform the HIV-ST; (3) document if intended users can successfully interpret contrived positive, negative, and invalid results; and (4) document if intended users can understand the key messages in the product labeling. Methods: This cross-sectional study recruited consenting adults who were representative of intended users of HIV self-testing from four community sites in Canadian provinces between June 2022 and January 2024. The results of the observed HIV self-tests were compared with results of the laboratory-based “gold standard” Abbott Alinity HIV Antigen/Antibody Combo test. Usability outcomes for critical and noncritical self-test procedure steps were also determined. Results: Overall, 951 participants were recruited and consented with 911 available for all analyses. With respect to socio-demographics: 84% of participants were between 18-45 years of age, 73% had at least college education, 48% were cis-male, and 45% were employed; 26% identified as White, 23% as African, Caribbean or Black, 5% as Indigenous [First Nations, Métis or Inuit], 33% as Asian, and 6% as LatinX. Primary performance analysis on the 911 completed HIV-ST revealed a positive percent agreement of 100% (1/1) and a negative percent agreement of 100% (880/880, 95% CI: 99.9-100%) with the comparator method. For usability determination, the average success rate for steps identified as “critical” for successful completion of the test was 94.1%. Approximately 97% of participants found the instructions easy to follow, and 98% of participants indicated that they would use the test again. Of the 465 participants who interpreted the strong positive, weak positive, negative, and invalid contrived results, most participants were able to interpret the results correctly. Conclusions: Having an oral fluid-based HIV self-test approved in Canada can offer an accurate, acceptable, and less invasive alternative to blood-based HIV self-testing. The addition of an oral-fluid self-test along with the current licensed blood-based HIV self-test could significantly increase HIV testing rates by offering individuals a choice of self-testing devices.

BackgroundTo develop effective public health policies, programs, and services tailored to the unique sexual health needs of migrant populations, it is essential to understand the myriad socio-ecological factors that influence their sexual health. This qualitative community-based participatory study aimed to explore factors influencing migrants’ sexual health at different socio-ecological levels in a Canadian setting.MethodsParticipants (n = 34) from African, Caribbean, Black; Latin American; South Asian; Middle Eastern, as well as East and Southeast Asian communities were recruited across Manitoba using printed flyers, community organizations, and social media. Individual interviews, conducted in English, French, Mandarin, Cantonese, Tagalog, Arabic, Swahili, and Tigrinya languages, explored questions relating to sexual health and experiences with service providers. Data were analyzed using reflexive thematic analysis and socio-ecological systems theory.ResultsThe study uncovered a range of individual, interpersonal, institutional, and socio-structural factors that affect the sexual health of migrants in Manitoba. Individual factors such as sexual health knowledge and testing practices, interpersonal factors like the type of sexual partnerships, institutional factors such as sexual health information needs, language, and service access barriers, and structural-level factors like gender norms and HIV stigma exerted a significant influence on the sexual health practices of study respondents. Sexual health awareness was influenced by various factors including length of time in Canada and involvement in community-based services. Study respondents identified issues related to access to HIV testing and sexual health information, as well as language barriers, racism in healthcare, and HIV stigma. Gender and social norms played a significant role in discouraging communication about sex and safer sex practices.ConclusionsThe study highlights the complex interplay of factors that influence the sexual health of migrants, and the need for targeted sexual health awareness campaigns and provision of sexual health information in languages spoken by migrants. Public health interventions focused on improving the sexual health outcomes for migrants should consider the socio-ecological elements identified in this study. These findings can inform public health campaigns to increase access to services and address sexual health inequities among migrant communities in Canada.

ABSTRACT Background: Among Indigenous people in Canada the incidence of HIV is 3.5 times higher than other ethnicities. In Manitoba First Nations, Metis and Inuit people are disproportionately represented (40%) among people who are new to HIV care. Northlands Denesuline First Nation (NDFN) identified the need to revisit their level of knowledge and preparedness for responding to the increasing rates of HIV. NDFN piloted a community readiness assessment (CRA) tool to assess its appropriateness for use in northern Manitoba. Methods: A First Nation and non-First Nation research team trained to administer the CRA tool at NDFN in Manitoba. Five informants were interviewed using the CRA tool and the responses were scored, analysed and reviewed at community workshops and with stakeholders to develop a 1-year action plan. Results: CRA training was best conducted in the community. Using the readiness score of 2.4 along with feedback from two workshops, community members, the research team and stakeholders, we identified priorities for adult education and youth involvement in programmes and planning. Conclusions: In response to the increasing incidence of HIV, a northern First Nation community successfully modified and implemented a CRA tool to develop an action plan for culturally appropriate interventions and programmes.