"The Culturally and Linguistically Diverse Community Is Not Just Minoritised But Ignored": Engaging Culturally and Linguistically Diverse Communities in Australia With Blood-Borne Viruses and Sexually Transmissible Infections Healthcare.

BACKGROUND

People from culturally and linguistically diverse (CALD) backgrounds who are living in high-income countries, are disproportionately impacted by blood-borne viruses and sexually transmissible infections (BBVs/STIs). Despite this, many do not engage with available preventive and treatment services due to a range of patient, provider and systems level barriers that make patient engagement challenging. This study explores ways to make healthcare services more acceptable and accessible to promote better health outcomes for Australian residents from CALD communities.

METHODS

Researchers of CALD backgrounds conducted in-depth interviews with 26 key stakeholders who work in the BBVs/STIs health care sector and advocate for or provide care to people from CALD communities. Most of these stakeholders were of CALD backgrounds. Interviews explored barriers to patient engagement, and discussed notions of intersectional stigma, quality health care, and strategies to reduce stigma and discrimination within health settings. Data were analysed using reflexive thematic analysis.

RESULTS

Four key themes were generated that describe and challenge inequitable BBVs and STIs care for CALD people in Australia and offer more inclusive and acceptable paths of engagement for this population. These themes are: (1) A paradigm shift in cultural orientation of the Australian healthcare system, (2) Addressing stigma, (3) Removing language barriers, and (4) Engaging CALD people as healthcare providers.

CONCLUSION

Results show that health service understanding of CALD people's cultural understandings and interpretations of health and illness is key to engaging these communities with healthcare services. This study highlights the need for BBVs/STIs services and Australia's health system in general, to adopt a more cross-cultural approach in the way it interacts with and addresses the health needs of patients from CALD backgrounds.

PATIENT OR PUBLIC CONTRIBUTION

This study used a codesign approach in which an advisory group drawn from CALD communities made a significant input in the study design in relation to cultural appropriateness and relevance. Also, some participants in the study have BBVs living experience which contributed in enriching the study data.