Health Equity Considerations for Screening and Diagnosis of Sexually Transmitted and Blood-Borne Infections Impacted by the COVID-19 Pandemic: A Scoping Review

Abstract

Introduction:

Timely access to sexually transmitted and blood-borne infections (STBBI) testing and linkages to care are directly dependent on confirmed medical diagnosis, referred to as the first element of the cascade of care. Access to STBBI testing was impacted by the COVID-19 pandemic in a variety of ways. This pandemic mobilized some public health innovations, reducing roadblocks in the STBBI cascade of care.

Objective:

The overarching objective of this scoping review was to identify and map available peer-reviewed and open-access gray literature on public health and community-based innovations for testing, screening, and diagnosis of STBBIs during the COVID-19 Pandemic, in Organization for Economic Co-operation and Development (OECD) countries.

Methods:

MEDLINE (Ovid), CINAHL (EBSCO), Embase (Elsevier), Social Services Abstracts (ProQuest), Sociological Abstracts (ProQuest), Google, https://clinicaltrials.gov/, and Canadian Agency for Drugs and Technologies in Health Gray Matters were searched between September 2022 and September 2023. During this period, title and abstract screening were completed by three pairs of reviewers. Full text screening and data extraction were completed by two pairs of reviewers. Conflicts were resolved by S.M.G. and J.G. Community engagement was iterative, including regular meetings (two per year) with key stakeholders and rights and title holders. No methodological deviations to note. Data are presented in figure and tabular form and summarized.

Results:

A total of 7,108 peer-reviewed literatures underwent title and abstract screening, and over 800 gray literatures were considered. Thirteen peer-reviewed and 43 gray literatures, on public health and community-based innovations for testing, screening, and diagnosis of STBBIs in OECD countries, were identified. Results confirmed STBBI resources were eliminated or redirected during the pandemic, while some were adapted, resulting in significant innovation and emphasizing the resourcefulness of those working in this service area. Although novel approaches were identified (e.g., barber shop-based testing), many innovations captured were examples of repurposing existing approaches or reintroducing innovations not implemented. Included literature represented 6/38 OECD countries and six of the common STBBIs. Community-based approaches, developed with existing community-led initiatives show great promise, and dominated the literature.

Conclusions:

The pandemic motivated public health and community-based innovation, including reimplementation of initiatives previously experiencing barriers to implementation. Many of these innovations shifted screening from clinical settings to community-based settings. Including gray literature enriched the review, as it highlighted ongoing research and community-led research that were not published in academic journals. This scoping review has identified several concepts and innovations that can be explored and evaluated further.

Introduction

Sexually transmitted and bloodborne infections (STBBIs), a significant public health crisis globally, include human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), chlamydia, gonorrhea, hepatitis B, hepatitis C, and infectious and congenital syphilis Common infections, there is a documented rise in STBBI globally, with more than 1 million STBBI being acquired each day.^1,2 A pressing public health concern in Canada and worldwide, STBBIs increase primary and secondary health and disease risk to individuals, families, and communities.³ For example, the transmission of HIV may be indirectly accelerated by other STBBIs, and, if left untreated, HIV may advance to AIDS.^4,5 Also, changes to immune and non-immune cells, because of contracted STBBIs (e.g., inflammation), can also increase risk for STBBIs and other medical diagnoses, such as cancer.^3–7

Surveillance, testing, screening, diagnosis, and care of STBBI were negatively impacted during the COVID-19 pandemic.^8,9 Notwithstanding, current and future response to STBBI can be informed by lessons learned from the COVID-19 pandemic. The pandemic illuminated the importance of clear and effective public health messaging, research, innovation, adapted interventions, and highlighted the necessity for collaboration and action.^8,9 Moreover, recent communications from the Canadian Government recognize that stigma, often associated with STBBIs, and the sensitive nature of the topic, warrant a person-centered [or person-focused] approach.^3,9 Person-focused innovations in STBBI prevention and care considers aspects such as a person’s circumstances, experiences, needs, and values, to offer individualized care with respect and dignity.^3,10 The Cascade-of-Care is a framework commonly used in health research and quality assurance to measure intervention progress according to steps in the delivery of treatment and care.^11–14 The first and arguably most important step of the cascade includes access to testing, screening, and diagnosis, relevant to effective surveillance, prevention, treatment, and eradication.

The Organization for Economic Co-operation and Development (OECD) is an international organization made up of 38 member countries that works with governments, policymakers, and citizens to advise public policy on a global scale.¹⁵ As such, the OECD facilitates comparative data and analysis on a variety of issues known to impact. For example, on the economic well-being of a country.¹⁵ It is noteworthy that in several OECD countries, including Australia, access to STBBI prevention and treatment services remained a public health priority during national COVID-19 lockdowns. This said, modifications were made to existing services, to ensure pandemic-related public health protocols were maintained.^9,15–17 For instance, a national Australian survey was conducted in 2020 to capture these data. Of the 21 sexual health service providers surveyed, 20 remained open for both in-person and telehealth appointments. While 40% (n = 8/21) suspended walk-in services, 75% (n = 16/21) reported no reduction in their overall operating hours during the pandemic.¹⁶ Prior to the pandemic, all 21 service providers offered self-collection for anal swabs for screening, and 18 offered self-collection for vaginal swabs. During the pandemic, 5 to 18 of 21 clinics increased their rate of self-collection for oropharyngeal swabs.¹⁶

During 2020, the Public Health Agency of Canada conducted a survey on the impact of COVID-19 on the delivery of STBBI prevention (including HIV), testing, and treatment in Canada, including harm reduction services.^9,18–21 Results from the 416 services providers who participated indicated that of those providing prevention, testing, and treatment for STBBIs, 66% (n = 275/416) experienced a decrease in demand for their services (likely associated with lockdowns), and 44% (n = 183/416) experienced a decrease in their ability to deliver their services.⁹ Throughout these first several months of the pandemic (March 2020 to December 2020), service providers across Canada reported creating new remote service, mobile outreach testing services, and delivery of harm reduction supplies among other initiatives.⁹

The objective of this scoping review is to identify and map literature describing person-focused innovations in STBBI screening and diagnosis during the COVID-19 pandemic in OECD countries. This review materialized from ongoing community consultation with key stakeholders and rights and title holders, facilitated by the Senior Author (JG). It has been identified broadly that to reduce the burden of STBBIs in Canada, innovative ways to advance access to STBBI care are necessary to meet national and international targets.¹ Such innovation can include development or improvement of preexisting processes, policies, products, or programs, with the aim of increasing quality, impact, and efficiency.^22,23 Before comparison and evaluation of such innovations can begin, it is important to identify and map what exists. A preliminary search of MEDLINE, the Cochrane Database of Systematic Reviews, and JBI Evidence Synthesis and registration was conducted by a librarian and Evidence Synthesis Coordinator (KH, JM), to confirm no current or underway systematic reviews or scoping reviews on the topic existed. The research question is: What person-focused innovation(s) existed for screening and diagnosis of notifiable STBBIs during the COVID-19 pandemic (March 11, 2020, to September 30, 2023)?

Materials and Methods

This scoping review was conducted in accordance with an a priori protocol (see: https://osf.io/z5vqm/), following the JBI (formerly known as Joanna Briggs Institute) methodology for scoping reviews^24,25 and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).²⁶

Inclusion and Exclusion Criteria

This scoping review considered peer-reviewed original research and gray literature, and included literature that described people seeking or administering person-focused innovations in STBBI testing, screening, and/or diagnosis in OECD countries during the COVID-19 pandemic. Demographic covariates often used for exclusion in medical and clinical literature were not ground for exclusion in this review (e.g., age, gender, sex). The STBBIs outlined in the surveillance report from Public Health Canada (2019) included in the review are: HIV, AIDS, chlamydia, gonorrhea, hepatitis B, hepatitis C, and (infectious and congenital) syphilis.^1,3,18,19 People seeking or administering screening and/or diagnosis for something other than the notifiable STBBIs were not included in this review. Literature that offers general recommendations for screening, testing, and diagnosis was not eligible. Work focusing on non-OECD countries was excluded in this review, nor work conducted prior to the pandemic. Literature published in English was included, dictated by the reviewers’ language abilities, financial, and time constraints.

Search Strategy

A limited search of MEDLINE AII (Ovid) was conducted by the first author and a Librarian (SGM, KH), to identify articles on the topic. The keywords contained in the titles and abstracts of relevant articles, and the index terms used to describe the articles, were used to develop a full search strategy for MEDLINE. A published search filter was used as originally designed for the OECD countries.²⁷ Another search filter was modified for the COVID-19 search concept, and the authors chose to limit inclusion to results published from March 2020 onward.²⁸ The MEDLINE search was reviewed by a second health sciences librarian using the Peer Review of Electronic Search Strategy (PRESS) guideline before being adapted for each individual database.²⁹ Although systematic reviews were not considered for the review, they were reviewed for citations.³⁰

The databases originally searched on September 20, 2022, included MEDLINE, CINAHL Full Text (EBSCO), Embase (Elsevier), Social Services Abstracts (ProQuest), and Sociological Abstracts (ProQuest) (Supplementary Appendix SA1). This search was rerun on September 11, 2023, with a publication date limit of 2022–present, after results were presented for community feedback (Spring, 2023) to capture the latest published results as per JBI scoping review methodologies. In March 2020, the World Health Organization (WHO) officially declared COVID-19 a pandemic, and in May 2023, WHO announced the end of COVID-19 as a global health emergency.³¹ These dates, including the decision to re-run the search, serve as the rationale for the inclusion criteria of this review, to reflect the innovations that were employed during subsequent Public Health restrictions. The Canadian Agency for Drugs and Technologies in Health or CADTH’s Gray Matters Lite resource was added to the search strategy, based on community feedback (CADTH; https://greymatters.cadth.ca. Accessed: September, 2023).

Study/Source of Evidence Selection

All identified citations were uploaded into Covidence Systematic Review Software (Veritas Health Innovation, Melbourne, Australia, available at www.covidence.org) and duplicates were automatically removed. Before title and abstract and full text review, the core research team (JG, SMG, JM, LW, RW, MC) engaged in a calibration exercise for which 10 literatures were uploaded to Covidence and screened by six independent reviewers for assessment against the inclusion criteria, after which a discussion occurred, and clarifications were made, as needed. The title and abstract review were then completed by the same six independent reviewers, two reviewers per source. Full-text literatures were retrieved and assessed in detail against the inclusion criteria by two of three independent reviewers (JM, LW, MC), with the assistance of two librarians (NS, KH). Any disagreements/conflicts that arose between the reviewers at each stage of the process were resolved by the first and senior author (SGM, JG), through discussion with the original reviewers. Results are reported according to PRISMA-ScR checklist and include a PRISMA flow diagram (Fig. 1).³²

FIG. 1.

Search results and study selection and inclusion process.³² OECD, Organization for Economic Co-operation and Development.

Data Extraction

Data were extracted from included literatures by two of six independent reviewers (JG, SMG, JM, LW, RW, MC), using a data extraction tool (Supplementary Appendix SA2) developed by two research librarians (NS, KH) in collaboration with the reviewers using Covidence 2.0 (Veritas Health Innovation, Melbourne, Australia, available at www.covidence.org). The extraction tool was tested with 10 studies during a calibration exercise; no significant revisions were made. Conflicts that arose were resolved by either the first or senior author (SMG, JG). As this review is a scoping review, no critical appraisal of the evidence was conducted.

Community Co-Creation, Collaboration, and Engagement

The need and desire for this review was identified by key stakeholders and rights and title holders (e.g., knowledge users, decision makers, service providers, people with lived experience, Indigenous people on Turtle Island). Evidence shows that engaging in community co-creation improves health research quality, from development of the question to application of the results.³³

In addition to two formal meeting presentations, regular informal feedback was obtained. For instance, the Atlantic Stakeholder Engagement on the COVID Impact on STBBI Services Working Group (SEWG) assisted with the development of the research question and provided iterative feedback as the protocol was developed and implemented. Made up of 17 members, from the four Atlantic provinces, SEWG includes people with lived experience related to STBBIs. Similarly, members of the Atlantic Interdisciplinary Research Network (AIRN) reviewed earlier drafts of the article and formal presentation(s) to assist with identifying gaps and highlight additional references and considerations. AIRN is a network of over 260 individuals and organizations working in the areas of Hepatitis C and HIV/AIDS in the Atlantic region.

Results

A total of 7,108 literatures underwent title and abstract screening, with 13 peer-reviewed and 43 gray literatures included (n = 56 total). The PRISMA Flow Diagram describes the search results and study selection and inclusion process (Fig. 1). Reasons for study exclusion include Before 2020 (n = 9), not OECD country (n = 32), incorrect focus/concept (n = 203), and beyond the first step of the cascade of care (n = 77). Fifteen literatures excluded from the peer-reviewed literature results were moved to the gray literature results, see Supplementary Appendix SA3 for full list of literatures excluded following full-text review.

Characteristics of Included Literature

Full citations and details of the 56 literatures included in the scoping review are provided in Supplementary Appendix SA4. Characteristics of each literature were listed and mapped as they relate to the research question, objectives, and community feedback. Included literatures were published between 2020 and 2023. Several types of literatures were identified during this review (Table 1), including varied study designs and methodologies, providing both quantitative and qualitative information. Seven interventions were identified, two semi-structured interviews and two focus groups. Gray literature that met search criteria are also included (Table 1).

Table 1.

Literature Types (n = 56)

Parameter	Results (counts)
Source types	Peer-reviewed (n = 13) Survey studies = 1 Mixed method studies = 1 Intervention studies = 7 Interviews = 2 Focus groups = 2
	Gray literature (n = 43) Study protocols = 11Commentaries = 1Websites = 8Reports = 6Conference abstracts = 15News articles = 1Infographics = 1

Review Findings

Population

The peer-reviewed literature (n = 13) included eight literatures focused on those seeking access to testing, screening, and/or diagnosis, while five focused on those administrating or facilitating these services. The peer-reviewed literature represented a total of 1,799 individual participants, 1,616 seeking and 183 administrating services. Several sub-categories were represented in this participant pool (Fig. 2a, b). Based on community feedback, and author consensus, results are shown separately for clarity, and to facilitate further examination of the differences between the types of literature,³⁴ should readers wish to pursue this.

FIG. 2.

(a) Population Descriptors in Peer-Reviewed Literature. (b) Population Descriptors in Included Gray Literature. LGBTQ2+, lesbian, gay, bisexual, transgender, queer or questioning, and two-spirit; STBBIs, sexually transmitted and blood-borne infections.

The peer-reviewed literature included people identifying as Indigenous (n = 6), Black (n = 20), Asian (n = 47), White (n = 420), and Hispanic/Latino (n = 77). Other descriptors or characteristics used to describe samples or populations in the peer-reviewed literature were people engaging in substance abuse (m = 86), housing insecure individuals (n = 729), transgender individuals (n = 10), lesbians or women who have sex with women (n = 31) and sexual minority men (SMM) (n = 213), which in many cases corresponded with terminology used in the gray literature—gay, homosexual, or men who have sex with men, which are not always interchangeable or synonymous terms.

The gray literature included terms representing identical populations, unique populations, and unspecified/non-specific (including geographic samples) (n = 13). For instance, 30 of the 43 included gray literatures described health care providers (n = 1), hospitalized inpatients (n = 4), men who have sex with men (MSM, n = 5), transgender individuals (n = 5), LGBTQ2+ individuals (n = 3), people who are unhoused (n = 4), people who use drugs (n = 5), people inexperienced with testing (n = 1), people at high risk of STBBI (n = 5), sex workers (n = 3), people of color (n = 4), geographic samples (n = 9), and people seeking STBBI testing (n = 4). Some literatures described more than one unique population (n >30). Population descriptors for included gray literatures are shown (Fig. 2b).

Context

All literatures included in the review were based on work completed in or about an OECD country, as per the review eligibility criteria. Of the 13 peer-reviewed literatures included, 61% were from the United States (n = 8), 15% from Canada (n = 2), and 8% from the United Kingdom (n = 1), Spain (n = 1), and Australia (n = 1). Of the 43 gray literatures included, 51% were from the United States (n = 22), 37% from Canada (n = 16), 4% from the United Kingdom (n = 2), and 2% from Australia (n = 1), Spain (n = 1), and Italy (n = 1). Most of the included literature focused on or included HIV testing options, but all STBBIs were represented in the literature extracted. Of the peer-reviewed literature (n = 13), 85% provided information on HIV testing (n = 11), with four providing information on Hepatitis C (n = 4), Gonorrhea (n = 4), Chlamydia (n = 4), and Syphilis (n = 4), and 1 on Herpes. Of the 43 gray literatures, four were unspecified, meaning that specific STBBIs were not reported. Of the gray literatures, 72% included information on HIV testing, screening, and diagnosis (n = 31), with eight providing information on Hepatitis C (n = 8), Gonorrhea (n = 8), Chlamydia (n = 8), and eight reporting on Syphilis (n = 8).

Concept : The innovation(s)

Counts and words used in the reviewed literature, when describing innovations in STBBI testing, screening, and diagnosis, or the first phase of the Cascade-of-Care, are summarized (Table 2).

Table 2.

Innovations in Testing, Screening, and Diagnosis of Sexually Transmitted and Blood-Borne Infections During the COVID-19 Pandemic

Concept or innovation	Peer-reviewed (n = 13) Tandem services (e.g., COVID-19 and HIV) = 3 Telehealth = 5 Text messages = 2 Collaboration with community-assets = 1 Peer support = 1 At-home testing = 6 Mobile outreach = 3 Application(app)-based outreach = 2
	Gray literature (n = 43) Point-of-care testing = 14 Self and home testing(e.g., mail outs) = 20 Express testing = 5 Friendship Networks/ Peer-to-peer = 2 Pharmacy-based testing = 1 Application(app)-based outreach = 1

COVID-19, Coronavirus disease; HIV, human immunodeficiency virus.

While 13 peer-reviewed literatures were included, some literatures reported on more than one innovation (23 innovations identified) (Table 2). Gray literatures tended to focus on specific or one innovation, with counts being reflective of the total number of literatures (n = 43). To further facilitate access and understanding of this information, and based on community feedback, innovation was mapped according to geographical location (Fig. 3a, b).

FIG. 3.

(a) Innovations by Country in Peer-Reviewed Literature. (b) Innovations by Country in Gray Literature.

By not limiting this review to Canada or North America, unique innovations were identified beyond our geographic boundaries. For instance, Lim et al. (2022) (United Kingdom) applied the plan-do-study-act mode to test, refine, and evaluate COVID-19 interventions designed to allow the continued provision of services while protecting the health and safety of staff and patients. Adaptations included free home HIV testing, providing virtual navigational support, increased use of phone, text, and email outreach, and increased virtual communication. Further, it is important to highlight interventions that include stories and perspectives from those who have historically been marginalized such as Wood et al. (2021) (United States) who reports on an intervention aimed at offering at-home testing to increase access to HIV testing and care among young cisgender men and transgender women.³⁵

Peer-reviewed literature (n = 13) included information on tandem services (e.g., COVID and HIV), telehealth, text messages, collaboration with community-assets, peer support, at-home testing, mobile outreach, and application (app)-based outreach. “Collaboration with community assets” was illustrated by Nwakoby et al. (2023), who completed an assessment of HIV-related knowledge and stigma among barbers, and facilitated discussion about potential roles of barbershops in improving HIV outcomes for Black men.³⁶ Moreover, gray literatures provided unique terminologies and perspectives, echoing with the phrase “collaboration with community assets”. For instance, these literature highlighted potential roles for pharmacies and “friendship networks,”³⁷ also referred to as peer-to-peer or peer networks in the peer-reviewed literature,³⁸ and several examples of point-of-care testing in the United States and Canada.^39–42 Point-of-care testing is medical diagnostic testing performed outside the clinical laboratory near where the patient is receiving care, often performed by non-laboratory personnel and the results are used for clinical decision making.⁴³

Discussion

This scoping review identified and mapped person-focused innovation(s) for testing, screening and diagnosis of notifiable STBBIs, during the COVID-19 pandemic. The results confirm many of our stakeholders’ and rights and title holders’ beliefs and experiences, that universally (OECD countries) services were impacted, either some eliminated or redirected, while others were adapted, resulting in significant innovation and highlighting the resilience and ingenuity of those working in this service area. Although some novel concepts were presented in the literature (e.g., barber shop-based testing), many innovations captured were examples of development or improvement of existing process, policy, product, or program, and/or reintroduction of proposed innovations previously not implemented.^39–42

A key aim of a scoping review is to organize and understand concepts and conceptual boundaries of a topic and map key underpinning concepts in a field of study.⁴⁴ This is a noteworthy component of this review for several reasons, including the dynamic nature of language, the differences in language detected between peer-reviewed and gray literature, and ongoing community engagement. First, STBBI is shorthand for sexually transmitted and blood-borne infections and holds different meaning for many, when contrasted to older nomenclator like STD or sexually transmitted disease.^45,46 An infection may not become a disease. This is relevant to many people living with, at risk of, or treating STBBIs, for several reasons, including many people with an infection are asymptomatic and may be unaware they are carrying.³ Use of dynamic language can be further illustrated by comparing the peer-reviewed and gray literature included in this review; peer-to-peer interventions were common, but went by several names, including “friendship networks” and “peer support.” This review further highlighted the valuable role scoping reviews play in the knowledge-to-action process and the impact of language.^24,47 For instance, the term stakeholder, a term commonly used in knowledge mobilization and JBI reviews, was identified as problematic during community engagement. Indigenous people are rights and titleholders who hold internationally recognized human rights. This includes legislation and mechanisms such as United Nations Declaration on the Rights of Indigenous Peoples and guidelines on land tenure.⁴⁸

The literature included in this review highlighted several population characteristics in agreement with Factors that Impact Vulnerability (FIV) to STBBIs an instrument developed by The Canadian Public Health Association that identifies priority populations, at higher risk of STBBIs.⁴⁹ The population categories are not mutually exclusive, but serve as a starting point from which relevant intersections between populations (e.g., First Nation, MSM) can be identified. At a population level, recognizing which populations experience STBBIs is key to including them in research, intervention and innovation development. In the case of primary or one-on-one care, this information initiates a comprehensive assessment to identify the unique risks of the individual, and to avoid assumption. Comprehensive, person-focused assessment (of literature and people) avoids assumptions and proliferating stigma. Further, these data also highlight the need for research that represents those most impacted by STBBI.⁵⁰

Strengths of the Review

There are several strengths to be noted in the creation and implementation of this scoping review. This review strictly adhered to current best-practice recommendations for scoping reviews, from project inception to completion. We considered diverse forms of evidence and literature, registered and published the protocol, had our search strategy developed and peer-reviewed by Librarians, and engaged in an iterative team approach to selecting studies. Our decision to include gray literature in this review deeply improved the breadth and inclusiveness of this review, ensuring diverse perspectives and terminologies were considered in identification and mapping.

Limitations of the Review

There are several limitations to this scoping review, many inherent to the design and methods. First, a scoping review is not a tool intended to assess quality, impact, and efficiency of included innovations;⁴⁴ thus, evaluation of literature was not conducted. Second, this review only included English literature, potentially resulting in selection bias. Practical challenges, such as time and funding constraints, made the use of translation services unfeasible for this project but can be addressed in subsequent work. The authors see this as a substantial limitation of the review, as language and literacy barriers have been shown to further marginalize populations and are established SDoH.⁵⁰ Another limitation to note is that the extraction of gray literature was not verified with the authors or their organizations. Therefore, it is possible that there are additional resources available. Finally, by limiting the search to OECD countries, we likely missed some innovations.

Conclusions

This scoping review identified and mapped 56 literatures detailing person-focused innovations in STBBI testing, screening and diagnosis, since 2020, noting where they are located, and which populations were targeted. This review supports that COVID-19 pandemic generated innovation in STBBI testing, screening, and diagnosis, including re-implementation of initiatives previously experiencing barriers to implementation. Many of these initiatives placed testing and screening in users’ hands and in community settings. The review demonstrates that there is limited peer-reviewed work on this topic, and that forthcoming work can better represent intersectional characteristics of people seeking or needing testing, screening and diagnosis, and under-researched STBBIs (those not identified in this review; e.g., papillomavirus). It also highlights the importance of including gray literature in scoping reviews, and the role scoping reviews can play in ensuring diverse words, concepts and languages are considered and captured before synthesis or intervention begin. Other considerations highlighted by this work include the need to evaluate pandemic preparedness for STBBI testing, screening, and diagnosis and the role community-engagement plays in identifying best innovations for “hard-to-reach” at risk communities.

Footnotes

Acknowledgments

The authors would like to thank The Atlantic Stakeholder Engagement on the COVID Impact on SEWG, Atlantic Interdisciplinary Research Network (AIRN), and all delegates at the 2023 Stakeholder Forum, Translating Lessons of the COVID-19 Response to Sustainable and Inclusive Sexual Health Promotion, based at Mount Saint Vincent University, and Canadian Public Health Association Annual Conference (May 2024), at the Halifax Convention Center. This work would not be possible without the time and effort these individuals and groups provided during research question conception to project completion. Important to note, each of these groups are composed of people representing several intersectional characteristics relevant to this work, including people living with or living with risk of STBBI, and those providing care services. The authors specially thank Queen’s University, Faculty of Health Sciences, JBI Comprehensive Systematic Review Training Program, JBI Center of Excellence in Systematic Reviews, Dalhousie University, and the University of International JBI Collaboration, based at the University of Adelaide (Australia), for training the team (S.M.G., J.M., M.C., and R.W.) on JBI design and methodology. Preliminary results of this work were presented at the Public Health Conference 2024 in Halifax, Nova Scotia. The full conference abstract is available on the Canadian Public Health Association website:

Authors’ Contributions

S.M.G.: Conceptualization (equal), methodology (equal), project administration (lead), visualization (equal), writing—original draft (lead), writing—review and editing (equal), supervision (supporting). J.M.: Conceptualization (equal), methodology (equal), project administration (supporting), visualization (equal), writing—original draft (equal), writing—review and editing (equal). L.W.: Conceptualization (equal), methodology (equal), visualization (equal), writing—original draft (equal), writing—review and editing (equal). M.C.: Methodology (equal), writing—review and editing (equal). R.W.: Methodology (equal), writing—review and editing (equal). K.H.: Conceptualization (equal), methodology (equal), writing—review and editing (equal), N.S.: Conceptualization (equal), methodology (equal), writing—review and editing (equal), M.P.-S.: Conceptualization (supporting), methodology (supporting), funding acquisition (lead), writing—review and editing (equal). J.G.: Conceptualization (equal), methodology (supporting), funding acquisition (supporting), writing—review and editing (equal), supervision (lead).

Review Registration Information

Original Registered Title: Mapping “Cascade of Care” for Human Immunodeficiency Virus (HIV) and sexually transmissible and blood-borne infections (STBBIs) in Organization for Economic Co-operation and Development (OECD): A scoping review protocol

Certified author(s): Kristy Hancock

Collaborating entity or institution: Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence

Date registered: September 14, 2022

Registered with: JBI Evidence Synthesis

Declarations

All the authors listed and community members consulted engage in work to improve diversity and inclusion in research. This review contributes to this body of work and aims to encourage it. Several authors listed and community members consulted are members of or work with populations highlighted in this work and represent both populations explored in this review.

Author Disclosure Statement

The authors declare no conflict of interest pertaining to this work.

Funding Information

Funding to conduct this review was provided by the Nova Scotia Advisory Commission on AIDS (the Commission) and Mount Saint Vincent University Committee on Research and Publications’ Internal Research Grant(s). L.W., J.M., R.W., and M.C. received compensation for their work from these sources.

Supplementary Material

Abbreviations Used

References

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