People who live with HIV who have temporary or precarious immigration status in Quebec face major barriers in accessing healthcare and antiretroviral treatments (ART). Since 2017, approximately 30% of people newly diagnosed with HIV have not been covered by government health insurance in Quebec (RAMQ) because of immigration issues (91 people in 2018). To respond to this challenge, a team of 24 professionals from community settings, universities, health clinics and other institutions led this community-based research.
Initiative Objectives and Goals
· To document the state of access to healthcare for people living with HIV with a temporary or precarious immigration status;
· To identify short-term solutions to allow access to treatment and care for those who have no healthcare coverage or a limited one because of their immigration
· To explore strategies to establish universal health coverage in Quebec for people living with HIV in this situation; and
· To develop amore complete research project.
The Role of this Initiative to End the HIV Epidemic
Promote collaborative work for a specific population between community organizations, clinics and institutions. Increase access to treatment and care for people to achieve an undetectable viral load to contribute to the reduction of HIV transmission. Restore one of people's fundamental rights, regardless of immigration status: access to health care.
Montréal, Québec, Saint-Jérôme, Québec
A REACH Collaboration
Principal co-investigators: Ken Monteith, Christina Zarowsky, Charlotte Guerlotté
Key performance indicators
Primary target audience
Policymakers involved in immigration, HIV and healthcare, social and community workers and healthcare professionals
Results We analyzed 22 interviews, 2 focus groups and 71 articles selected from the scientific literature (2018-2019).
Some barriers are directly linked to different immigration statuses, be these administrative, political, structural and/or financial. However, this project showed that other barriers are not directly linked to immigration status, for example the lack of knowledge of healthcare providers regarding the realities of immigration can have an impact on the healthcare of immigrants. The people with temporary or precarious immigration status also lacked knowledge of existing services and had difficulty navigating the Quebec healthcare system.
Healthcare access alternatives exist because of volunteer work and the benevolence of healthcare professionals. Free access to follow up blood tests is more complex, but has been made possible in some cases thanks to collaborations between institutions. As a result, access to treatment is usually a "collage" of temporary solutions from Doctors, Pharmacists and individuals. This ensemble of care is accessible thanks to the benevolence of healthcare professionals and often their volunteer work. All the same, these alternatives are limited in their financial and human resources and face administrative, structural and political barriers.
For more results, watch our CAHR 2020 presentation video.
This project demonstrated that collaborative work between community and medical services has a beneficial impact on better access to healthcare services for people without healthcare coverage.