Understanding barriers and facilitators to HIV testing in Canada from 2009–2019: A systematic mixed studies review
Background: HIV testing is a core pillar of Canada’s approach to sexually transmitted and blood-borne infection (STBBI) prevention and treatment and is critical to achieving the first Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target. Despite progress toward this goal, many Canadia...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Public Health Agency of Canada
2021-02-01
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| Series: | Canada Communicable Disease Report |
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| Online Access: | https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-2-february-2021/systematic-review-barriers-hiv-testing-canada-2009-2019.html |
| _version_ | 1818981118731354112 |
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| author | Claudie Laprise Clara Bolster-Foucault |
| author_facet | Claudie Laprise Clara Bolster-Foucault |
| author_sort | Claudie Laprise |
| collection | DOAJ |
| description | Background: HIV testing is a core pillar of Canada’s approach to sexually transmitted and blood-borne infection (STBBI) prevention and treatment and is critical to achieving the first Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target. Despite progress toward this goal, many Canadians remain unaware of their status and testing varies across populations and jurisdictions. An understanding of drivers of HIV testing is essential to improve access to HIV testing and reach the undiagnosed.
Objective: To examine current barriers and facilitators of HIV testing across key populations and jurisdictions in Canada.
Methods: A systematic mixed studies review of peer-reviewed and grey literature was conducted identifying quantitative and qualitative studies of barriers and facilitators to HIV testing in Canada published from 2009 to 2019. Studies were screened for inclusion and identified barriers and facilitators were extracted. The quality of included studies was assessed and results were summarized.
Results: Forty-three relevant studies were identified. Common barriers emerge across key populations and jurisdictions, including difficulties accessing testing services, fear and stigma surrounding HIV, low risk perception, insufficient patient confidentiality and lack of resources for testing. Innovative practices that could facilitate HIV testing were identified, such as new testing settings (dental care, pharmacies, mobile units, emergency departments), new modalities (oral testing, peer counselling) and personalized sex/gender and age-based interventions and approaches. Key populations also face unique sociocultural, structural and legislative barriers to HIV testing. Many studies identified the need to offer a broad range of testing options and integrate testing within routine healthcare practices.
Conclusion: Efforts to improve access to HIV testing should consider barriers and facilitators at the level of the individual, healthcare provider and policy and should focus on the accessibility, inclusivity, convenience and confidentiality of testing services. In addition, testing services must be adapted to the unique needs and contexts of key populations. |
| first_indexed | 2024-12-20T17:26:14Z |
| format | Article |
| id | doaj.art-0af33d3899a740878f8ff57a3a9c4163 |
| institution | Directory Open Access Journal |
| issn | 1481-8531 |
| language | English |
| last_indexed | 2024-12-20T17:26:14Z |
| publishDate | 2021-02-01 |
| publisher | Public Health Agency of Canada |
| record_format | Article |
| series | Canada Communicable Disease Report |
| spelling | doaj.art-0af33d3899a740878f8ff57a3a9c41632022-12-21T19:31:33ZengPublic Health Agency of CanadaCanada Communicable Disease Report1481-85312021-02-0147210512510.14745/ccdr.v47i02a03Understanding barriers and facilitators to HIV testing in Canada from 2009–2019: A systematic mixed studies reviewClaudie Laprise0Clara Bolster-Foucault1Public Health Agency of Canada, Health Security and Infrastructure Branch, Public Health Capacity and Knowledge Management Unit, Québec Regional Office; Montréal, QCPublic Health Agency of Canada, Health Security and Infrastructure Branch, Public Health Capacity and Knowledge Management Unit, Québec Regional Office; Montréal, QCBackground: HIV testing is a core pillar of Canada’s approach to sexually transmitted and blood-borne infection (STBBI) prevention and treatment and is critical to achieving the first Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target. Despite progress toward this goal, many Canadians remain unaware of their status and testing varies across populations and jurisdictions. An understanding of drivers of HIV testing is essential to improve access to HIV testing and reach the undiagnosed. Objective: To examine current barriers and facilitators of HIV testing across key populations and jurisdictions in Canada. Methods: A systematic mixed studies review of peer-reviewed and grey literature was conducted identifying quantitative and qualitative studies of barriers and facilitators to HIV testing in Canada published from 2009 to 2019. Studies were screened for inclusion and identified barriers and facilitators were extracted. The quality of included studies was assessed and results were summarized. Results: Forty-three relevant studies were identified. Common barriers emerge across key populations and jurisdictions, including difficulties accessing testing services, fear and stigma surrounding HIV, low risk perception, insufficient patient confidentiality and lack of resources for testing. Innovative practices that could facilitate HIV testing were identified, such as new testing settings (dental care, pharmacies, mobile units, emergency departments), new modalities (oral testing, peer counselling) and personalized sex/gender and age-based interventions and approaches. Key populations also face unique sociocultural, structural and legislative barriers to HIV testing. Many studies identified the need to offer a broad range of testing options and integrate testing within routine healthcare practices. Conclusion: Efforts to improve access to HIV testing should consider barriers and facilitators at the level of the individual, healthcare provider and policy and should focus on the accessibility, inclusivity, convenience and confidentiality of testing services. In addition, testing services must be adapted to the unique needs and contexts of key populations.https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-2-february-2021/systematic-review-barriers-hiv-testing-canada-2009-2019.htmlhivbarriersfacilitatorstestingscreeningcanadasystematic reviewmixed studieskey populations |
| spellingShingle | Claudie Laprise Clara Bolster-Foucault Understanding barriers and facilitators to HIV testing in Canada from 2009–2019: A systematic mixed studies review Canada Communicable Disease Report hiv barriers facilitators testing screening canada systematic review mixed studies key populations |
| title | Understanding barriers and facilitators to HIV testing in Canada from 2009–2019: A systematic mixed studies review |
| title_full | Understanding barriers and facilitators to HIV testing in Canada from 2009–2019: A systematic mixed studies review |
| title_fullStr | Understanding barriers and facilitators to HIV testing in Canada from 2009–2019: A systematic mixed studies review |
| title_full_unstemmed | Understanding barriers and facilitators to HIV testing in Canada from 2009–2019: A systematic mixed studies review |
| title_short | Understanding barriers and facilitators to HIV testing in Canada from 2009–2019: A systematic mixed studies review |
| title_sort | understanding barriers and facilitators to hiv testing in canada from 2009 2019 a systematic mixed studies review |
| topic | hiv barriers facilitators testing screening canada systematic review mixed studies key populations |
| url | https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-2-february-2021/systematic-review-barriers-hiv-testing-canada-2009-2019.html |
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