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Background: In 2018, the Public Health Agency of Canada (PHAC) published a systematic review to calculate the risk of sexual transmission of human immunodeficiency virus (HIV) in the context of antiretroviral therapy (ART). In 2022, PHAC commissioned the Canadian Agency for Drugs and Technologies in Health (CADTH) to conduct a rapid review of evidence published since 2017. We undertook a meta-analysis of relevant studies from these two reviews. Methods: Studies from the rapid review that adequately assessed exposure (HIV viral load) and outcome (HIV seroconversion) were included and assessed for risk of bias (RoB) and certainty of evidence. Results were pooled to estimate the risk of HIV transmission per 100 person-years. Results: Three studies from the rapid review were eligible for inclusion and one was excluded after RoB assessment. In the remaining studies examining risk among people living with HIV who take ART and maintain a suppressed viral load (fewer than 200 copies/ mL, measured every 4–6 months), no sexual transmissions of HIV were observed. The pooled incidence estimate based on these studies, and one from the 2018 PHAC review, was zero transmissions/100 person-years (95% CI: 0.00–0.10). No studies in the rapid review provided data on the risk of sexual transmission of HIV in situations of varying levels of viral load. Conclusion: This update highlights the consistency of evidence since the 2018 PHAC review. There remains no evidence of HIV transmission to sexual partners when a person living with HIV is on ART and maintains a suppressed viral load. [ABSTRACT FROM AUTHOR]

Background: Black men who have sex with men (MSM) experience disproportionately high HIV incidence globally. A comprehensive, intersectional approach (race, gender, and sexuality or sexual behavior) in understanding the experiences of Black MSM in Canada along the HIV prevention and care continuums has yet to be explored., Objective: This scoping review aims to examine the available evidence on the access, quality, gaps, facilitators, and barriers of engagement and identify interventions relevant to the HIV prevention and care continuum for Black MSM in Canada., Methods: We conducted a systematic database search, in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist, of the available studies on HIV health experience and epidemiology concerning Black MSM living with or without HIV in Canada and were published after 1983 in either English or French. Searched databases include MEDLINE, Excerpta, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, the NHUS Economic Development Database, Global Health, PsycInfo, PubMed, Scopus, and Web of Science. From the 3095 articles identified, 19 met the inclusion criteria and were analyzed., Results: Black MSM in Canada consistently report multiple forms of stigma and lack of community support contributing to an increased HIV burden. They experience discrimination based on their intersectional identities while accessing HIV preventative and treatment interventions. Available data demonstrate that Black MSM have higher HIV incidences than Black men who have sex with women (MSW) and White MSM, and low preexposure prophylaxis knowledge and HIV literacy. Black MSM experience significant disparities in HIV prevention and care knowledge, access, and use. Structural barriers, including anti-Black racism, homophobia, and xenophobia, are responsible for gaps in HIV prevention and care continuums, poor quality of care and linkage to HIV services, as well as a higher incidence of HIV., Conclusions: Considering the lack of targeted interventions, there is a clear need for interventions that reduce HIV diagnoses among Black MSM, increase access and reduce structural barriers that significantly affect the ability of Black MSM to engage with HIV prevention and care, and address provider's capacity for care and the structural barriers. These findings can inform future interventions, programming, and tools that may alleviate this HIV inequity., International Registered Report Identifier (irrid): RR2-10.1136/bmjopen-2020-043055., (©Jemal Demeke, Pascal Djiadeu, Abban Yusuf, Darren Lovell Whitfield, David Lightfoot, Fiqir Worku, Gamji Rabiu Abu-Ba'are, Lawrence Mbuagbaw, Sulaimon Giwa, LaRon E Nelson. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 18.01.2024.)

Introduction: Globally, rates of HIV are disproportionately high among black men who have sex with men (MSM). In Canada, race, gender and sexuality have been investigated as separate factors that influence quality of care within and progression along the HIV care continuum. Traditional compartmental approaches to synthesising the HIV care continuum literature do not sufficiently account for intersectional experiences and marginalisation of Black MSM (BMSM). Moreover, there is limited research outlining access to and quality of care as specific barriers to progression along the care continuum among BMSM in Canada., Objectives: The primary objective of this scoping review is to assess the state of the science regarding the influence of access to and quality of HIV care continuum outcomes for BMSM in Canada., Methods and Analysis: We will conduct a systematic search of published literature of quantitative and qualitative studies published on Canadian BMSM's healthcare and HIV status. The searches will be conducted through MEDLINE, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, the NHUS Economic Development Database, Global Health, APA PsychInfo, PubMed and Web of Science., Eligibility Criteria: Eligible studies will include data on black MSM living with or without HIV in Canada and must be published after 1983 in either English or French. Screening and data extraction will be conducted in duplicate. Any discrepancies that arise will be resolved by consulting a third author. The findings will subsequently be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews., Ethics and Dissemination: Ethics approval is not required as secondary published data will be used. Our findings will be disseminated as peer-reviewed manuscripts, at conferences, student rounds and could be of interest to government health agencies and HIV/AIDS service organisations., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: In 2001, 50%-55% of French-speaking minority communities did not have access to health services in French in Canada. Although Canada is officially a bilingual country, reports indicate that many healthcare services offered in French in Anglophone provinces are insufficient or substandard, leading to healthcare discrepancies among Canada's minority Francophone communities., Objectives: The primary aim of this scoping systematic review was to identify existing gaps in HIV-care delivery to Francophone minorities living with HIV in Canada., Study Design: Scoping systematic review., Data Sources: Search for studies published between 1990 and November 2019 reporting on health and healthcare in Francophone populations in Canada. Nine databases were searched, including Medline, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, the National Health Service Economic Development Database, Global Health, PsychInfo, PubMed, Scopus and Web of Science., Study Selection: English or French language studies that include data on French-speaking people with HIV in an Anglophone majority Canadian province., Results: The literature search resulted in 294 studies. A total of 230 studies were excluded after duplicates were removed. The full texts of 43 potentially relevant papers were retrieved for evaluation and data extraction. Forty-one studies were further excluded based on failure to meet the inclusion criteria leaving two qualitative studies that met our inclusion criteria. These two studies reported on barriers on access to specialised care by Francophone and highlighted difficulties experienced by healthcare professionals in providing quality healthcare to Francophone patients in Ontario and Manitoba., Conclusion: The findings of this scoping systematic review highlight the need for more HIV research on linguistic minority communities and should inform health policymaking and HIV/AIDS community organisations in providing HIV care to Francophone immigrants and Canadians., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Language is a social determinant of health. Addressing social determinants of health is paramount to successful progression along the HIV-care continuum. Canada is a bilingual country with French and English as official languages. There are few studies to date that have focused on the impact of being a French-speaking linguistic minority on the HIV-care continuum. The primary objective of this scoping, systematic review of literature is to evaluate existing gaps in access to HIV- care among French-speaking people living with HIV in Canada. Our primary outcome is healthcare services availability and access for French- speaking people living with HIV., Methods and Analyses: Our scoping, systematic review will draw on a systematic search of published literature, both quantitative and qualitative studies published on French-speaking individuals' healthcare and HIV status in Canada, with particular emphasis on the province of Ontario. We will conduct our search in MEDLINE, the Excerpta Medica Database, the Cumulative Index to Nursing and Allied Health Literature, Web of Science, EBSCO and Google Scholar for work published between 1990 and 2018. Identified articles will be screened in duplicate and full-text articles of relevant studies will be retrieved. Data will also be extracted by two researchers working independently. Any discrepancies that arise will be resolved by consensus or by consulting a third author. Our findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses., Ethics and Dissemination: Our proposed research will not be conducted with human participants. We will only use secondary published data and therefore ethics approval is not required. Our findings will be disseminated as peer reviewed manuscripts at conferences and student rounds, and could be of interest to government health agencies and local HIV/AIDS service organisations., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)