Co-Developing & Piloting a New Model of Care Delivery for Migrant People Living with HIV in Montréal

As of June 2019, immigrants accounted for 82.8% of Canada's annual population growth. Immigrants represent an increasing proportion of people living with HIV (PLWH) in Canada. In fact, a Canadian surveillance report indicated that immigrants accounted for 40% of all new HIV diagnoses reported in 2018. Efficient access to HIV care for new immigrants has significant individual-level health benefits (e.g. reducing the morbidity and mortality associated with HIV infection), which can translate into major society-level benefits (e.g. prevention of HIV transmission to others). However, immigrant PLWH face longstanding and complex barriers that prevent them from accessing and adhering to HIV care compared to native-born citizens. For example, immigrants often lack medical coverage and have limited financial resources to access HIV medications. Furthermore, immigrants are often unable to fluently speak English or French, making medical terminology harder to understand for them and hindering their ability to navigate the Canadian healthcare system. Also, personal barriers such as fear of being stigmatized when accessing HIV care, and organizational barriers such as scheduling appointments at HIV clinics, have both intensified with the COVID-19 pandemic. A possible solution to mitigating or eliminating a number of the barriers immigrants face is to conceive and implement a new model of HIV care specific to this population. This likely means giving healthcare providers a set of specific guidelines to follow when working with this population and integrating clinical care with social programs from community-based organizations that serve immigrants. My research program seeks to do the following: (1) co-design a model of care with patients, clinicians, community organizations, and hospital administrative decision-makers; (2) co-design an efficient implementation strategy with all stakeholders; and (3) test this new model of care at two major HIV care centres in Montréal.