Interventions for Increasing HIV Testing Uptake in Migrants: A Systematic Review of Evidence

Abstract

Migrants have been identified as being at greater risk for late HIV testing and diagnosis. Late diagnosis is of concern because timely diagnosis and initiation of treatment can both optimise health outcomes and reduce transmission. We reviewed and evaluated interventions that aimed to increase HIV testing uptake in migrant populations. Of 6511 papers retrieved, 10 met the inclusion criteria and were included in the review. Three types of interventions were identified (exposure to HIV prevention messages, HIV education programs, and direct offer of testing). All interventions were based on individual models of behaviour change targeting migrants or GPs. While important, interventions that also address broader health system and structural factors that contribute to late HIV-diagnosis in at-risk members of migrant populations are needed. Integrating PITC into existing primary healthcare settings shows promise of creating an enabling environment within patient-doctor relationships that can encourage HIV testing uptake among migrant populations.

Factors associated with access to HIV testing among international students in Japanese language schools in Tokyo

“…All of these factors may contribute to increased HIV risk [10][11][12]. Moreover, migrants have poor access to health services, including HIV testing, in the host country [13][14][15].…”

“…Migrants are also more likely to have a delayed HIV diagnosis [15]. They have specific legal and administrative barriers to access HIV testing, along with cultural and language barriers [13][14][15]. Most of the studies on access to HIV testing among migrants have been conducted in Europe and North America [13][14][15].…”

“…They have specific legal and administrative barriers to access HIV testing, along with cultural and language barriers [13][14][15]. Most of the studies on access to HIV testing among migrants have been conducted in Europe and North America [13][14][15]. HIV testing uptake in migrants and ethnic minorities range from 21-73% in US, and 23-64% in Europe [13].…”

Intersectional Stigma and Multi-Level Barriers to HIV Testing Among Foreign-Born Black Men From the Caribbean

“…Police cooperation with Immigration and Customs Enforcement (ICE) in non-sanctuary cities under President Trump's administration has fostered ambivalence and mistrust of the police in Black immigrant communities (77)(78)(79)(80). There is evidence that some migrants underutilized HIV testing resources because of misconceptions about immigration laws and that seeking care or a positive test could result in deportation (81,82). HIV criminalization laws that broadly penalize alleged or perceived non-disclosure of, and exposure to, HIV and nonintentional HIV transmission with incarceration can be an even more detrimental policy-level barrier to HIV screening (83,84) among FB Blacks because being convicted of a crime can be grounds for deportation.…”

“…Aung et al argue that provider-initiated testing and counseling may be the most promising because they foster trust in both the provider and in health systems (82).…”