Social and structural barriers and facilitators to HIV healthcare and harm reduction services for people experiencing syndemics in Manitoba: study protocol
Linda Larcombe,
Laurie Ireland,
Ken Kasper,
Yoav Keynan,
Neora Pick,
Michael Payne,
Jared Bullard,
Kathleen Deering,
Julianne Sanguins,
Katharina Maier,
Andrea Krüsi,
Zulma Vanessa Rueda,
Margaret Haworth-Brockman,
Cheryl Sobie,
Enrique Villacis,
Kimberly Templeton,
Lauren MacKenzie,
Tara Myran,
Adrienne Meyers
Affiliations
Linda Larcombe
4 Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
Laurie Ireland
8 Manitoba HIV Program, Winnipeg, Manitoba, Canada
Ken Kasper
4 Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
Yoav Keynan
1 Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
Neora Pick
10 Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
Michael Payne
9 Nine Circles Community Health Centre, Winnipeg, Manitoba, Canada
Jared Bullard
1 Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
Kathleen Deering
6 Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
Julianne Sanguins
3 Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
Katharina Maier
5 Criminal Justice, The University of Winnipeg, Winnipeg, Manitoba, Canada
Andrea Krüsi
Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
Zulma Vanessa Rueda
1 Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
Margaret Haworth-Brockman
3 Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
Cheryl Sobie
1 Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
Enrique Villacis
1 Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
Kimberly Templeton
8 Manitoba HIV Program, Winnipeg, Manitoba, Canada
Lauren MacKenzie
4 Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
Tara Myran
12 Indigenous Development, University of Winnipeg, Winnipeg, Manitoba, Canada
Adrienne Meyers
13 Laboratory Integration, Office of Population and Public Health, Indigenous Services Canada, Winnipeg, Manitoba, Canada
Introduction In Manitoba, Canada, there has been an increase in the number of people newly diagnosed with HIV and those not returning for regular HIV care. The COVID-19 pandemic resulted in increased sex and gender disparities in disease risk and mortalities, decreased harm reduction services and reduced access to healthcare. These health crises intersect with increased drug use and drug poisoning deaths, houselessness and other structural and social factors most acutely among historically underserved groups. We aim to explore the social and structural barriers and facilitators to HIV care and harm reduction services experienced by people living with HIV (PLHIV) in Manitoba.Methods and analysis Our study draws on participatory action research design. Guiding the methodological design are the lived experiences of PLHIV. In-depth semi-structured face-to-face interviews and quantitative questionnaires will be conducted with two groups: (1) persons aged ≥18 years living or newly diagnosed with HIV and (2) service providers who work with PLHIV. Data collection will include sex, gender, sociodemographic information, income and housing, experiences with the criminal justice system, sexual practices, substance use practices and harm reduction access, experiences with violence and support, HIV care journey (since diagnosis until present), childhood trauma and a decision-making questionnaire. Data will be analysed intersectionally, employing grounded theory for thematic analysis, sex-based and gender-based analysis and social determinants of health and syndemic framework to understand the experiences of PLHIV in Manitoba.Ethics and dissemination We received approval from the University of Manitoba Health Ethics Research Board (HS25572; H2022:218), First Nations Health and Social Secretariat of Manitoba, Nine Circles Community Health Centre, Shared Health Manitoba (SH2022:194) and 7th Street Health Access Centre. Findings will be disseminated using community-focused knowledge translation strategies identified by participants, peers, community members and organisations, and reported in conferences, peer-reviewed journals and a website (www.alltogether4ideas.org).
