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BackgroundWeb or Internet-based surveys are increasingly popular in health survey research. However, the strengths and challenges of Web-based surveys with people living with human immunodeficiency virus (HIV) are unclear. ObjectiveThe aim of this article is to describe our experience piloting a cross-sectional, Web-based, self-administered survey with adults living with HIV using a community-based participatory research approach. MethodsWe piloted a Web-based survey that investigated disability and rehabilitation services use with a sample of adults living with HIV in Canada. Community organizations in five provinces emailed invitations to clients, followed by a thank you/reminder one week later. We obtained survey feedback in a structured phone interview with respondents. Participant responses were transcribed verbatim and analyzed using directed content analysis. ResultsOf 30 people living with HIV who accessed the survey link, 24/30 (80%) initiated and 16/30 (53%) completed the survey instrument. A total of 17 respondents participated in post-survey interviews. Participants described the survey instrument as comprehensive, suggesting content validity. The majority (13/17, 76%) felt instruction and item wording were clear and easy to understand, and found the software easy to navigate. Participants felt having a pop-up reminder directing them to missed items would be useful. ConclusionsStrengths of implementing the Web-based survey included: our community-based participatory approach, ease of software use, ability for respondents to complete the questionnaire on one’s own time at one’s own pace, opportunity to obtain geographic variation, and potential for respondent anonymity. Considerations for future survey implementation included: respondent burden and fatigue, the potentially sensitive nature of HIV Web-based research, data management and storage, challenges verifying informed consent, varying computer skills among respondents, and the burden on community organizations. Overall, results provide considerations for researchers conducting community-based participatory Web-based survey research with people living with HIV.

Some older gay men (50+) experience diminished quality of life (QOL) due to historical and ongoing discrimination in addition to living through a collective trauma—the pre-HAART era of the HIV/AIDS epidemic—characterized by the absence of treatment and rampant discrimination targeting gay men. A growing body of literature, however, illustrates that older gay men demonstrate remarkable resilience but little is known about how QOL is conceptualized and how these conceptualizations are potentially shaped by pre-HAART experiences. The current study drew on constructivist grounded theory methods to examine how QOL is conceptualized in light of the sociohistorical relevance of pre-HAART. Twenty Canadian based gay men aged 50+ participated in semi-structured interviews via Zoom. Ultimately, QOL is understood as experiencing contentment, which is made possible by the development and implementation of three key processes: (1) developing and cultivating meaningful connections, (2) growing into and embracing identity, and (3) appreciating the capacity to do what brings joy. QOL for this group is greatly informed by a context of disadvantage, and the demonstrated resilience warrants further investigation to meaningfully support the overall well-being of older gay men. [ABSTRACT FROM AUTHOR]

OBJECTIVE: HIV testing remains a central strategy for HIV prevention for its ability to link those who test positive to treatment and support. In Canada, national guidelines have recently changed as part of standard primary care to recommend voluntary HIV testing for those aged 16-64 years. Using results from a nationally representative survey, we examined individual and jurisdictional factors associated with voluntary testing. METHODS: A total of 2,139 participants were sampled using a regionally stratified, two-stage recruitment process. English or French interviews (by phone or online) were conducted during May 2011. Voluntary testing was defined as testing at least once for reasons other than blood donation, insurance purposes, immigration screening or research participation. Weighted logistic regression analysis (including socio-demographic, sexual activity, HIV/AIDS knowledge and jurisdictional factors of HIV prevalence and anonymous testing availability) were conducted for the overall sample, and stratified by sex. RESULTS: Twenty-nine percent (29%) of survey participants reported at least one lifetime voluntary HIV test. For the full-sample model, the following were associated with increased odds of testing: age DISCUSSION: Sex differences should be considered when designing interventions to increase testing uptake. Jurisdictional factors, including HIV prevalence and testing modality, should be investigated further. KEY WORDS: HIV; testing; anonymous testing; Canada Can J Public Health 2015;106(2):e4-e9 doi: 10.17269/CJPH.106.4625 OBJECTIF: Le depistage du VIH demeure une strategie centrale en matiere de prevention du virus, car il permet d'aiguiller les personnes seropositives vers les traitements et le soutien disponibles. Au Canada, les lignes directrices nationales ont change recemment dans le cadre des soins primaires normalises, et l'on recommande maintenant le depistage volontaire du VIH pour les 16 a 64 ans. A l'aide des resultats d'une enquete representative nationale, nous avons examine les facteurs individuels et les facteurs lies a la region administrative associes au depistage volontaire. METHODES: En tout, 2 139 participants ont ete echantillonnes selon un processus de recrutement en deux etapes, stratifie selon la region. Des entretiens en anglais ou en franpais (par telephone ou en ligne) ont ete menes en mai 2011. Le depistage volontaire etait defini comme etant un depistage au moins une fois pour une raison autre que pour donner du sang, a des fins d'assurance ou decontrole des immigrants ou pour participer a une etude de recherche. Des analyses de regression logistique ponderees (incluant les facteurs sociodemographiques, d'activite sexuelle, de connaissance du VIH et du sida et les facteurs de prevalence du VIH et de disponibilite du depistage anonyme selon la region administrative) ont ete menees pour l'echantillon global, puis stratifiees selon le sexe. RESULTATS: Vingt-neuf p. cent (29 %) des participants de l'enquete ont declare avoir subi au moins un depistage volontaire du VIH au cours de leur vie. Pour le modele utilisant l'echantillon entier, les facteurs suivants ont ete associes a une probabilite de depistage accrue : l'age DISCUSSION: Il faudrait tenir compte des differences entre les sexes lorsqu'on conpoit des interventions pour accroftre le recours au depistage. Les facteurs comme la prevalence du VIH et les modalites de depistage dans la region administrative devraient faire l'objet d'etudes plus poussees. MOTS CLES: VIH; depistage; depistage anonyme; Canada, Despite a range of educational campaigns and policies designed to increase voluntary human immunodeficiency virus (HIV) testing in Canada, one in four Canadians living with the disease are unaware of [...]

Public health scholarship is increasingly attuned to the structural determinants of health, such as the associations between macro-level policy and population health outcomes. Yet the ways public healthcare services are specifically made available through political and legislative decisions remain relatively under-explored. Using the critical research strategy of institutional ethnography, this study charts how political leadership transitions and legislative processes animate local public health service implementation activities. We investigated the feasibility of introducing an online sexually transmitted and blood-borne infections (STBBI) testing service to improve sexual healthcare access for gay, bisexual, queer, and other men who have sex with men in Ontario, Canada. Data were collected between June 2019 and June 2020. We conducted interviews with healthcare providers, sexual health program developers and managers, and other public health professionals with expertise in STBBI testing (n = 23), stakeholder meeting observations, and analyses of key texts (e.g. provincial policies and legislation). We uncovered that interpretations of provincial legislation posed a barrier to the online STBBI testing model, and we explicated the work of gaining decision-maker support for this new service during a period of austerity. In response to the election of political leadership who de-funded local public health, participants strategically framed arguments in favour of online testing using discourses of evidence, equity, and cost savings. Our article provides an empirical case study of the mechanisms by which political and legal dimensions direct the implementation of health services, shaping population health outcomes, and health equity in turn. [ABSTRACT FROM AUTHOR]

Introduction: We sought to explore the professional, personal and community domains of physician retention in 4 rural communities in Alberta and to develop a preliminary framework for physician retention. Methods: We used a qualitative, collective case study design to study 4 rural communities (cases) in Alberta that retained family physicians for 4 years or longer. Participants included physicians, staff members, spouses and community members. Data collected from interviews, documents and observations were analyzed individually, and similarities and differences across all cases were assessed. Results: A range of factors that could influence physicians' decisions to stay in a particular community were described by participants. Within the professional domain, physician supply, physician dynamics, scope of practice and practice set-up were common across all communities, and innovation, and management and support emerged from some communities. The personal factors, goodness-of-fit, individual choice, and spousal and family support were present in all communities. Four community factors--appreciation, connection, active support, and physical and recreational assets--emerged across all communities, and reciprocity was present in 3 communities. From these data, we developed a preliminary retention framework. Conclusion: Physicians, policy-makers and community members are encouraged to consider the 3 retention domains of professional, personal and community. Introduction : Nous avons voulu explorer les dimensions professionnelle, personnelle et communautaire de la fidelisation des medecins dans quatre communautes rurales de l'Alberta et elaborer un cadre preliminaire de fidelisation des effectifs medicaux. Methodes : Nous avons employe un modele d'etude de cas qualitatif et collectif pour analyser quatre communautes rurales (cas) de l'Alberta qui ont conserve leurs medecins de famille pendant quatre ans ou plus. Les participants incluaient des medecins, des employes, des conjoints et des membres de la communaute. Les donnees recueillies a partir d'entrevues, de documents et d'observations ont fait l'objet d'analyses individuelles et nous avons evalue les similitudes et les differences entre tous les cas. Resultats : Les participants ont decrit un eventail de facteurs susceptibles d'influer sur la decision des medecins de rester dans une communaute en particulier. Pour ce qui est de la dimension professionnelle, l'offre de medecins et la dynamique des medecins, de meme que le champ de pratique et l'organisation de la pratique ont ete des facteurs communs a toutes les communautes, tandis que l'innovation, la gestion et le soutien se sont distingues dans certaines. Parmi les facteurs personnels, mentionnons le degre d'ajustement, les choix personnels et le soutien des conjoints et de la famille, observes dans toutes les communautes. Quatre facteurs communautaires, soit l'appreciation, les liens, le soutien actif et les installations materielles et recreatives, sont ressortis dans toutes les communautes, tandis que la reciprocite a ete notee dans trois communautes. A partir de ces donnees, nous avons elabore un cadre preliminaire pour favoriser la fidelisation. Conclusion : Nous encourageons les medecins, les decideurs et les membres de la communaute a tenir compte de ces trois dimensions de la fidelisation : professionnelle, personnelle et communautaire., INTRODUCTION Primary care physicians provide a variety of health services to rural areas (1,2) and contribute to the health and well-being of rural residents and communities. (3) Yet, health care [...]