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The HIV case management acuity assessment tool will be the first case management acuity tool that addresses the realities of the Canadian socioeconomic and health coverage context, and specifically addresses the concerns of Black people living with HIV in Ontario.

Stock image of someone holding the HIV red ribbon

The HICMAAT will support engagement in the HIV care cascade for Black people living with HIV in Ontario and mitigate racial disparities in health. We will be testing a tool for identifying and categorizing case management needs among Black people living with HIV in Ontario.

The design of this study includes a qualitative phase followed by a quantitative phase. The quantitative phase is divided into two parts. It consists of an electronic survey and a pilot testing of the tool to determine its psychometric properties.

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We will conduct in-depth interviews among HIV care providers, people living with HIV and other stakeholders in HIV care (managers, carers, family, etc.).

We will use a purposeful sampling approach to reach people involved in HIV care for Black people living with HIV. We will reach out to:

  • Clinics in Ontario that provide care to Black people
  • HIV care providers
  • People living with HIV
  • Other stakeholders will form a panel of experts

We aim to interview 30 people: 10 healthcare providers, 10 Black people living with HIV, and 10 other stakeholders.

Through in-depth interviews, participants will be asked to use their experience to identify and describe the factors which affect people’s ability to engage in HIV care.

The transcripts from these interviews will be coded into themes. These themes will be used to generate variables that will be converted into a list of items that will be presented back to the panel of experts to determine the content validity of the items.

The same 30 stakeholders from the qualitative phase will be asked to complete a survey. After the survey is complete, we will use the results to produce a preliminary version of the tool which will be ready for pilot testing.

Health workers will be invited to complete an electronic survey set up in REDCap. REDCap is a secure web application for building and managing online surveys and databases. The survey will constitute basic sociodemographic information and a list of items that affect a person’s ability to engage in HIV care. This list of items will be derived from the literature and from the in-depth interviews. For each item, the experts will vote on whether the item is: 1. essential, 2. important but not essential, or 3. not important. Participants will be offered the opportunity to take part in a draw for gift cards valued at $50.

A content validity ratio will be computed that will allow us to select only items that at least 50% of the panelist deem essential.

We will apply the tool to 200 Black people living with HIV seeking care at TAIBU Community Health Centre and Moyo Health and Community Services.

African, Caribbean, and Black people living with HIV seeking care from the participating health centres (TAIBU and Moyo) will be approached to determine if they are interested in taking part in the study. All those who consent will be invited to respond to questions on the tool which will help determine their acuity. The questionnaire will include basic sociodemographic information and all the items on the preliminary HICMAAT tool. A random subset of 20 consenting participants will be contacted 1 week later to measure test-retest reliability.