Determinants of delayed healthcare access and stigma associated with pandemic SARS-CoV-2 infec-tion: findings from a pilot study in the immigrant population in Catania (Sicily Region, Southern Italy)

Background: the Coronavirus disease 2019 (COVID-19) pandemic may have aggravated existing social and healthcare inequalities among particular population groups, such as ethnic minorities, who showed increased susceptibility to SARS-CoV-2 infection.

Objectives: to characterize risk profiles or determinants of delayed healthcare access, as well as knowledge, risk perception, behaviour, and social stigma concerning SARS-CoV-2 infection in the immigrant population in the city of Catania (Sicily Region, Southern Italy).

Design: pilot, descriptive study.

Setting and participants: the immigrant population in Catania.

Main outcomes measures: an ad-hoc questionnaire was prepared and administered to the participants of the target population. In addition, a web-based data collection platform and a web-based survey addressed to healthcare providers were developed.

Results: 74 immigrant subjects (mean age: 39 years) voluntarily compiled the questionnaire with varying response rates per question: 77% of the participants were male, 59.5% were from Africa, 29.7% from Asia, 6.7% from South America, and 4.1% did not specify their origin. Fifty-three percent (35/66 responses) found it easy to access healthcare services. However, 25.8% (17/66 responses) found it difficult to understand written information concerning their health. Regarding vaccination services, 67.3% of subjects (35/62 responses) had no difficulty in receiving information on mandatory vaccinations and/or vaccination centres in Italy, and 79.7% (51/64 responses) were vaccinated against COVID-19. In relation to other primary prevention issues, 71.4% of participants (45/63 responses) stated they did not know or had never been tested for HIV, 64.4% (38/59 responses) declared they had not heard of or knew nothing about antibiotic resistance, and 30.4% (21/69 responses) had not heard or knew nothing about antibiotic use.

Conclusions: health services seem to be accessible and effective among the immigrant population in Catania. However, identified determinants of delayed healthcare access included factors concerning mainly health literacy and possibly the socioeconomic status of the population studied. Primary prevention issues that need to be addressed due to low awareness or stigmatization among the immigrant population include antibiotic use and resistance, and infectious diseases such as HIV/AIDS.