Background: Migrants from certain regions are at increased risk of key infectious diseases (including HIV, tuberculosis (TB), hepatitis B and hepatitis C). Although guidelines increasingly recommend integrated screening for multiple infections to reduce morbidity little is known about what migrants and healthcare professionals think about this approach. Methods: Prospective qualitative study in Leicester, United Kingdom within a novel city-wide integrated screening programme in three iterative phases to understand views about infections and integrated screening. Phase 1 focus groups (nine) with migrants from diverse communities (n = 74); phase 2 semi-structured interviews with healthcare professionals involved in the screening pathway (n = 32); phase 3 semi-structured interviews (n = 23) with individuals having tested positive for one/more infections through the programme. Analysis was informed by the constant comparative process and iterative across phases 1–3. Findings: Migrants’ awareness of TB, HIV and hepatitis B/C varied, with greater awareness of TB and HIV than hepatitis B/C; perceived susceptibility to the infections was low. The integrated screening programme was well-received by migrants and professionals; concerns were limited to data-sharing. As anticipated, given the target group, language was cited as a challenge but mitigated by various interpretation strategies. Interpretation: This large qualitative analysis is the first to confirm that integrated screening for key infectious diseases is feasible, positively viewed by, and acceptable to, migrants and healthcare professionals. These findings support recent guideline recommendations and therefore have important implications for policy-makers and clinicians as programmes of this type are more widely implemented in diverse settings. Funding: National Institute for Health Research.
Bibliographical noteFunding Information:
Data on the outcomes from these communicable diseases suggest that migrants are more likely to have adverse outcomes, including late presentation to care [ 10 , 11 ], and more aggressive disease processes [10–13] ; this therefore underscores the importance of early diagnosis and management of communicable diseases in preventing morbidity, mortality and onward transmission  . This position is supported by several guidelines from the National Institute for Health and Care Excellence (NICE) and other national/international bodies which advocate screening for key infections  including active and latent TB  , HIV  , hepatitis B and hepatitis C [ 17 , 18 ].
We thank all of the study participants for giving up their time and sharing their views and experiences. We thank Paul Underwood for assisting with the focus groups in Phase 1. We thank staff from Leicester College Curriculum Area ESOL (particularly Geoff Saul, Rominder Sandhu, Pam Sargeant and Munawara Sattar); and Leicester City CCG ? for their assistance in facilitating recruitment and organisation of focus groups and interviews.
© 2020 The Authors
- Hepatitis B
- Hepatitis C
- Primary care