Assessing the acceptability of dried blood spot testing for HIV and STBBI among Métis people in a community driven pilot project in Alberta, Canada

Abstract

Background Little literature exists on culturally grounded approaches for addressing human immunodeficiency virus (HIV) and sexually transmitted and blood-borne infections (STBBI) among Métis people. The goal of this mixed-methods research was to explore the experiences of Métis community members participating in a dried blood spot testing (DBST) for HIV/STBBI pilot for Métis communities in Alberta, Canada, with the aim of assessing the acceptability of this testing method. Methods Grounded in community-based and Indigenous research approaches and working in partnership with a Métis community-based organization, data collection included a survey and four gathering circles with Métis DBST recipients at one of two community events, and semi-structured interviews with three DBST providers. Results Twenty-six of the 30 DBST recipients completed surveys, and 19 DBST recipients participated in gathering circles. Survey results suggest DBST is a highly acceptable STBBI testing method to Métis community members. Thematic analysis of gathering circle and interview transcripts revealed four broad themes related to the participants’ experiences with DBST related to its acceptability (i. ease of DBST process, ii. overcoming logistical challenges associated with existing STBBI testing, iii. Reducing stigma through health role models and event-based, and iv. Métis-specific services). Conclusions These findings illustrate the potential for DBST to be part of a culturally grounded, Métis-specific response to HIV and STBBI.

The Red River Cart Model: a Métis conceptualization of health and well-being in the context of HIV and other STBBI

“…Existing mainstream approaches to services in the health system focus on individual-level interventions based upon the biomedical model, which are inadequate in addressing the health needs of the Métis (Auger, 2019). Métis-specific research has emphasized the importance of providing culturally safe care specific to Métis peoples in order to improve access to health care (Landy et al, 2022;Monchalin et al, , 2020Monchalin et al, , 2022. Similar to other Indigenous groups, the Métis conceptualize health in a holistic and multidimensional way which extends beyond the well-being of the individual.…”

“…Several models of holistic wellness grounded in First Nations cultures have been described in the literature; however, little literature has discussed Métis conceptualizations of health and well-being, which is a knowledge gap acknowledged by Métis and public health researchers (Kumar et al, 2012). While existing research has focused on topics of culturally safe care or defining Métis health and well-being from a physical or mental perspective, there is a lack of research addressing Métis culturally safe care within the realm of HIV/STBBI care, or Métis conceptualizations of health and well-being for those living with or affected by HIV/STBBI (Landy et al, 2022).…”

Estimating the Proportion of People Living With HIV Who May Benefit From the Reverse Algorithm for the Diagnosis of Incident Syphilis

“…7,8 We sought to estimate the percentage of PLWH with a nonreactive treponemal test at care entry who might benefit from the reverse algorithm for a future diagnosis of incident syphilis. Furthermore, the implementation and expansion of lowbarrier syphilis testing that does not require venipuncture as a first step in the reverse screening algorithm, including both rapid treponemal testing 9,10 and dried blood spot (DBS) specimen collection for laboratory-based treponemal testing [11][12][13][14] in outreach settings and at home, 15 may fill an important gap in diagnosing syphilis among PLWH. The Syphilis Health Check (SHC; Trinity BioTech, Jamestown, NY), a Food and Drug Administration-cleared, Clinical Laboratory Improvement Amendments-waived rapid treponemal test, has sensitivities ranging from 50% to 100% and specificities greater than 90% depending on the testing environment, population, and comparison reference test.…”

“…9,[16][17][18][19] Dried blood spot specimen collection is acceptable and can be performed by the client or a provider. 11,14,15 The sensitivities (>90%) and specificities (>99%) of DBS-based treponemal testing are high, including among PLWH. [11][12][13]…”

“…The Syphilis Health Check (SHC; Trinity BioTech, Jamestown, NY), a Food and Drug Administration–cleared, Clinical Laboratory Improvement Amendments–waived rapid treponemal test, has sensitivities ranging from 50% to 100% and specificities greater than 90% depending on the testing environment, population, and comparison reference test 9,16–19 . Dried blood spot specimen collection is acceptable and can be performed by the client or a provider 11,14,15 . The sensitivities (>90%) and specificities (>99%) of DBS-based treponemal testing are high, including among PLWH 11–13 …”