Attributes that influence testing decisions for sexually transmitted and blood-borne infections: A qualitative study among diverse people in Canada.

Abstract

BackgroundSexually transmitted and blood-borne infections (STBBIs) disproportionately affect key populations in Canada. For example, recent estimates suggested that the proportion of people living with hepatitis C is the highest among people who use injection drugs and that gay, bisexual and other men who have sex with men represent a high proportion of new cases of infectious syphilis. Understanding what STBBIs test users and potential testers perceive as important aspects of testing will help inform testing initiatives. We aimed to determine aspects of STBBI testing that are important to a diverse range of key populations in Canada.MethodsWe conducted qualitative interviews and focus groups with people from key populations (gay, bisexual, and other men who have sex with men; African, Caribbean, or Black individuals; Indigenous individuals; sex workers; people who use substances and injection drugs) and people who do not identify as a key population member. We conducted a thematic analysis.ResultsTwo major themes emerged: stigma and inequality, and journey into and through the healthcare system. Within the first theme, participants had diverse perspectives on how aspects of their identity interacted with willingness to seek testing. Within the second theme, participants discussed aspects of testing. Test costs, wait times, and testing accuracy were all viewed as important, but differing perspectives emerged about privacy of testing and receiving results, testing location, and who administers the test.ConclusionsParticipants' perspectives on STBBI testing and willingness to test were informed by their experiences and aspects of their identity.