Determinants of effective interventions for HIV prevention, treatment, and care to address inequitable HIV outcomes among Black Women of African Descent (BWAD) in High-Income Countries: Systematic review protocol.

ABSTRACT

BACKGROUND: In High-Income Countries (HICs) HIV/AIDS continues to disproportionally affect Black Women of African Descent (BWAD) and other racialized groups and is now a major public health concern. Despite the multiple efforts, evidence is limited on the effectiveness of HIV interventions to address the HIV outcomes inequalities among BWAD. This protocol outlines the methodological process of a systematic review that will gather quantitative and qualitative data to examine existing determinants of effective HIV prevention, treatment, and care interventions to address the HIV outcomes disparities and inequities among BWAD in HICs. METHODS: A systematic review of eligible articles will be conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A comprehensive search of the literature will be made in MEDLINE(R) ALL (Ovid), Embase (Ovid), CINAHL (EBSCO Host), and Global Health (Ovid). Peer-reviewed studies involving the experience of BWAD in HICs; different HIV prevention, treatment, and care interventions both in the community and in a clinical setting; studies that report on the experience of BWAD on HIV intervention/ service including different levels of barriers and facilitators; reports of original research and peer-reviewed articles based on qualitative, quantitative, and mixed study designs published in English from 1980 onwards in HICs will be included. A narrative synthesis, thematic synthesis, and descriptive quantitative analysis of both extracted qualitative and quantitative data will be undertaken. CONCLUSION: Substantial changes including tailored interventions are needed to address the inequities in HIV outcomes that disproportionally impact BWAD in HICs. Understanding the determinants of the effectiveness of BWAD-focused HIV interventions is critical to stemming the HIV epidemic and reducing the burden of the disease and poor health outcomes experienced by BWAD in HICs Our study finding will inform the multi level and multisectoral stakeholder including public health, community-based organizations and nongovernmental civil society organization engaged in BWAD HIV and health policy and practice in HICs. Findings from this review will be used to guide effective response to HIV/AIDS using an equity-driven policy and practice framework. TRIAL REGISTRATION PROSPERO registration number CRD42023458938.