Both HIV and COVID are stigmatized and disproportionately impact minoritized populations (Yuvaraj, 2020; Nkengasong, 2022). This stigma stems from fear and misinformation - two factors best addressed in the primary care setting. This study aimed to determine facilitators and barriers to HIV, PrEP and COVID vaccination screenings for minoritized populations in clinical settings.

Methods

Our qualitative pilot study utilized semi-structured interviews. Patients (n = 9) who identified as racial, ethnic, sexual and gender minoritized individuals were recruited via online surveying. PCPs (n = 6) were recruited via convenience sampling. The 15 transcripts were coded for facilitators and barriers and organized using the Socio-Ecological Model (McLeroy, et. al., 1988).

Results

As PCPs commonly stated systemic and policy-based barriers to care, many patients raised concerns about PCP availability and access to the EMR and health literate material. Patients and PCPs agreed that community stigma was a barrier to care, but had differing perceptions on its facilitators. PCPs did not acknowledge the agency of patients, while patients noted the exhausting nature of navigating racist healthcare systems. While patients considered the importance of PCP attitudes and behaviors, PCPs did not discuss any interpersonal factors. Depending on context and experience as a PCP or patient, some of the facilitators doubled as barriers.

Conclusions

Building the PCP-patient relationship can address stigma. Culturally Responsive Communication (CRC), which translates diversity, equity, inclusion, and justice through clinician reflexivity into patient interactions and antiracist care, can reshape the culture of medicine. Our call for CRC not only necessitates building the capacity of PCPs to practice this skill but can contribute to routinizing screenings for highly stigmatized conditions.