Barriers and enablers that influence the uptake of HIV testing among heterosexual migrants in the Netherlands.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2024
Historique:
received: 07 02 2024
accepted: 12 09 2024
medline: 9 10 2024
pubmed: 9 10 2024
entrez: 9 10 2024
Statut: epublish

Résumé

Heterosexual migrant men and women in the Netherlands often face barriers to accessing health services, including HIV testing, that may lead to late-stage HIV diagnoses. This study explored factors of influence in the usage of HIV testing among heterosexual migrants. Qualitative evaluation with semi-structured interviews at the Amsterdam-based AIDS Healthcare Foundation (AHF) Checkpoint and one focus group discussion (FGD) conducted during June-July 2023 with 19 participants: interviews with 12 heterosexual migrants from low- or middle-income countries (LMICs) and FGD (n = 5) and interviews (n = 2) with 7 key informants from the (public) health sector. Recorded interviews were transcribed and thematically analyzed, using the framework of Andersen's Expanded Behavioral Model of Health Services Use. In total, 55 themes emerged from the interviews and the FGD. Examples include insufficient availability of information on HIV and testing services, and difficulty in accessing these services (e.g. the barrier of the online appointment system of the Centre for Sexual Health (CSH)). HIV test participants expressed free, rapid testing, no appointment required, and a positive experience during their HIV test as enablers to test in the future. Results from key informants showed that poor health literacy and lack of clarity on the healthcare system's guidelines were barriers for heterosexual migrants in accessing information on HIV and testing services. It also revealed past initiatives and interventions that were successful in reaching at-risk groups such as the integration of HIV testing into sexually transmitted infection (STI) testing, but that were subsequently discontinued due to financial constraints. Factors contributing to a low HIV test uptake were participants' perception of limited accessibility of CSH facilities, insufficient available information on HIV (testing) services, and low perception of HIV risk. Unclear policies on accessing HIV/STI testing services at CSHs, and potential missed opportunities for HIV testing at general practitioners were contributing factors identified by key informants.

Sections du résumé

BACKGROUND BACKGROUND
Heterosexual migrant men and women in the Netherlands often face barriers to accessing health services, including HIV testing, that may lead to late-stage HIV diagnoses. This study explored factors of influence in the usage of HIV testing among heterosexual migrants.
METHODS METHODS
Qualitative evaluation with semi-structured interviews at the Amsterdam-based AIDS Healthcare Foundation (AHF) Checkpoint and one focus group discussion (FGD) conducted during June-July 2023 with 19 participants: interviews with 12 heterosexual migrants from low- or middle-income countries (LMICs) and FGD (n = 5) and interviews (n = 2) with 7 key informants from the (public) health sector. Recorded interviews were transcribed and thematically analyzed, using the framework of Andersen's Expanded Behavioral Model of Health Services Use.
RESULTS RESULTS
In total, 55 themes emerged from the interviews and the FGD. Examples include insufficient availability of information on HIV and testing services, and difficulty in accessing these services (e.g. the barrier of the online appointment system of the Centre for Sexual Health (CSH)). HIV test participants expressed free, rapid testing, no appointment required, and a positive experience during their HIV test as enablers to test in the future. Results from key informants showed that poor health literacy and lack of clarity on the healthcare system's guidelines were barriers for heterosexual migrants in accessing information on HIV and testing services. It also revealed past initiatives and interventions that were successful in reaching at-risk groups such as the integration of HIV testing into sexually transmitted infection (STI) testing, but that were subsequently discontinued due to financial constraints.
CONCLUSION CONCLUSIONS
Factors contributing to a low HIV test uptake were participants' perception of limited accessibility of CSH facilities, insufficient available information on HIV (testing) services, and low perception of HIV risk. Unclear policies on accessing HIV/STI testing services at CSHs, and potential missed opportunities for HIV testing at general practitioners were contributing factors identified by key informants.

Identifiants

pubmed: 39383170
doi: 10.1371/journal.pone.0311114
pii: PONE-D-24-04886
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0311114

Informations de copyright

Copyright: © 2024 Martinez Martinez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Auteurs

Veronica Martinez Martinez (V)

Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.

Hermen Ormel (H)

KIT Royal Tropical Institute, Amsterdam, the Netherlands.

Eline L M Op de Coul (ELM)

Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.

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