Access to HIV prevention, testing and care among people with a migration background in Euregio Meuse-Rhine: a needs and assets assessment

This study addresses disparities among people with a migration background (PMB) and those in less-urban regions, across the HIV prevention and care continuum (HIVPCC). We conducted a needs assessment and assets assessment to identify gaps between existing initiatives and persisting barriers. The research was conducted in the Euregio Meuse-Rhine (EMR), encompassing bordering regions in Belgium, Germany, and the Netherlands, and involved in-depth interviews with fifteen first-generation PMB, including nine with HIV. Six factors influencing PMB access to the HIVPCC were identified: past experiences with sexually transmitted infections (STIs) or HIV; HIV stigma and social dynamics; confidence and communication with healthcare providers and social workers; healthcare system navigation; precarity; and knowledge and beliefs about HIV/STIs. Existing assets mostly target individual or interpersonal levels, are often inaccessible due to language barriers, inadequately match PMB's living conditions and culture, and are irregular and hyperlocal. Recommendations include enhancing cultural sensitivity, adopting participatory approaches, tailoring outreach activities to legal situations and cultural context, and fostering cooperation between healthcare and social work institutions. This study underscores the importance of considering societal and institutional dynamics in bridging gaps in the HIVPCC for PMB, advocating for targeted interventions that promote inclusivity and equity.