Integrated screening of migrants for multiple infectious diseases: qualitative study of a city-wide programme

BackgroundMigrants from certain regions are at increased risk of key infectious diseases(includingHIV, tuberculosis(TB), hepatitis B and hepatitis C). Although guidelines increasinglyrecommendintegratedscreening for multipleinfectionsto reduce morbidity little is known about whatmigrants and healthcare professionals think about this approach. MethodsProspective qualitative study in Leicester, United Kingdom within anovel city-wide integrated screening programmein three iterative phases to understand viewsabout infections andintegrated screening.Phase 1 focus groups(nine)with migrants from diverse communities( n=74);phase 2 semi-structured interviews with healthcare professionals involved in the screeningpathway(n=32); phase 3 semi-structured interviews(n=23)with individuals having tested positive for one/more infectionsthrough the programme. Analysis was informed by the constant comparative process and iterative across phases 1-3.FindingsMigrants’ awareness of TB, HIV and hepatitis B/C varied, with greater awareness of TB and HIV than hepatitisB/C;perceived susceptibility tothe infectionswas low. The integratedscreeningprogramme was well-receivedby migrantsand professionals; concerns were limited to data-sharing.As anticipated, given the target group, language was cited as a challengebut mitigated by variousinterpretation strategies.InterpretationThis large qualitative analysis is the first to confirm that integrated screening for key infectious diseasesisfeasible, positively viewed by,and acceptable to,migrantsand healthcare professionals. Thesefindings support recent guidelinerecommendations and thereforehave important implications for policy-makers and clinicians as programmes of this type are more widely implemented in diverse settings.