Barriers in accessing HIV care for Francophone African, Caribbean and Black people living with HIV in Canada: a scoping review

Abstract

IntroductionIn 2001, 50%–55% of French-speaking minority communities did not have access to health services in French in Canada. Although Canada is officially a bilingual country, reports indicate that many healthcare services offered in French in Anglophone provinces are insufficient or substandard, leading to healthcare discrepancies among Canada’s minority Francophone communities.ObjectivesThe primary aim of this scoping systematic review was to identify existing gaps in HIV-care delivery to Francophone minorities living with HIV in Canada.Study designScoping systematic review.Data sourcesSearch for studies published between 1990 and November 2019 reporting on health and healthcare in Francophone populations in Canada. Nine databases were searched, including Medline, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, the National Health Service Economic Development Database, Global Health, PsychInfo, PubMed, Scopus and Web of Science.Study selectionEnglish or French language studies that include data on French-speaking people with HIV in an Anglophone majority Canadian province.ResultsThe literature search resulted in 294 studies. A total of 230 studies were excluded after duplicates were removed. The full texts of 43 potentially relevant papers were retrieved for evaluation and data extraction. Forty-one studies were further excluded based on failure to meet the inclusion criteria leaving two qualitative studies that met our inclusion criteria. These two studies reported on barriers on access to specialised care by Francophone and highlighted difficulties experienced by healthcare professionals in providing quality healthcare to Francophone patients in Ontario and Manitoba.ConclusionThe findings of this scoping systematic review highlight the need for more HIV research on linguistic minority communities and should inform health policymaking and HIV/AIDS community organisations in providing HIV care to Francophone immigrants and Canadians.

Community perspectives on addressing and responding to HIV-testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) among African, Caribbean and Black (ACB) people in Ontario, Canada

“…Our findings support previous research in this area finding that HIV-related stigma increases vulnerability to HIV infection by reducing access to HIV prevention, testing, and presenting barriers to treatment, care, and support for people living with HIV [ 30 ]. ACB community members continue to face stigma as a result of assumptions that HIV/AIDS is an epidemic brought to Canada by the “outsiders”/“foreigners” and is therefore an ACB people’s disease; associating the epidemic to stigmatized sexual behaviors such as sexual partner concurrency, extramarital sex, sex work, and drug use [ 34 ].…”

“…FGD participants included community members and leaders, service providers, decision-makers and other knowledge users. Given the well-recognized gaps in HIV care delivery to HIV-diagnosed Francophone ACB people in Canada [ 30 ], FGDs were conducted in English and French. Each FGD was led by a facilitator who was supported by a note-taker.…”

Community Perspectives on Addressing and Responding To HIV-Testing, Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) Among African, Caribbean and Black (ACB) People in Ontario, Canada

“…Our ndings support previous research in this area nding that HIV-related stigma increases vulnerability to HIV infection by reducing access to HIV prevention, testing, and presenting barriers to treatment, care, and support for people living with HIV [30]. ACB community members continue to face stigma as a result of assumptions that HIV/AIDS is an epidemic brought to Canada by the "outsiders"/"foreigners" and is therefore an ACB people's disease; associating the epidemic to stigmatized sexual behaviors such as sexual partner concurrency, extramarital sex, sex work, and drug use [34].…”

Barriers to access and utilization of healthcare services for minority-language speakers with neurodevelopmental disorders: A scoping review

“…Common to both groups is the language discordance between practitioners and patients, which leads to communication breakdowns and increased patient stress ( 6 , 58 ). Moreover, limited availability of services in minority-languages also leads to lower quality of care and longer wait times ( 8 , 9 , 20 , 33 , 34 , 40 , 52 ). Minority-language speakers also consistently report discrimination and negative attitudes on the part of healthcare practitioners ( 7 , 10 , 36 ) and challenges linked to access to qualified interpreters ( 7 , 34 , 36 ).…”

“…A key barrier encountered by minority language speakers is discordance between them and their healthcare practitioner's preferred or known language, which in turn can lead to communication breakdowns that can have important consequences for patients' health and well-being ( 6 ). Other barriers include the use of ad hoc interpreters ( 7 ), a reduced number of available services ( 8 , 9 ), and barriers linked to negative attitudes held by healthcare workers regarding minority-language speakers ( 7 , 10 ). Additionally, in the context of pediatric healthcare, parents of children from minority-language families also face barriers.…”