Good acceptability of HIV, HBV, and HCV screening during immigration medical check-up amongst migrants in France in the STRADA study

Introduction The prevalence of HIV, hepatitis B, and hepatitis C amongst migrants in France is high. Thus, effective screening and follow-up is needed. The mandatory medical check-up for residency application is an opportunity to offer rapid HIV and hepatitis testing. The main objective of the STRADA study is to create a feasible and acceptable screening strategy for migrants. Within the STRADA study, this qualitative research examined the acceptability of conducting screening tests in the context of residency application. Methods We conducted a qualitative study amongst legal migrants over 18 years of age with sufficient knowledge of the French, English, or Arabic language. Interviews were performed following a semi-structured interview guide of open-ended questions. Interviews were transcribed verbatim and subsequently analyzed through thematic analysis. Results We interviewed 34 migrants. Mean age was 32.6 (min-max: 19, 59) years. The participants’ region of origin was mostly Sub-Saharan Africa and the main reason for migrating to France was family reunification. Migrants' acceptability of HIV and hepatitis testing was high. Participants who accepted testing indicated a benefit for individual health and to avoid transmission. Most preferred rapid tests; reluctance was related to anxiety about the immediate results and the perceived reliability of rapid tests. Migrants' knowledge about HIV was satisfactory, but inadequate for hepatitis. Screening in the context of a compulsory medical visit did not present an obstacle for acceptability. Some expressed concern in the case of HIV but when explained, the independence between obtaining the residence permit along with screening and access to medical care was well understood. Discussion Medical check-ups at immigration centers is an opportunity to screen for HIV and hepatitis which is considered acceptable by migrants. Informing migrants that test results do not affect residency applications, and incorporating their preferences, are all important to optimize the acceptability of screening.


What experience or training did the researcher have?
All researchers have been trained in qualitative research prior to the start of the study. Relationship with participants 6. Was a relationship established prior to study commencement No relationship was established before starting the study.
7. What did the participants know about the researcher? Participants didn't know anything about the researchers.
8. What characteristics were reported about the interviewer/facilitator?
No characteristics were reported. Participants only knew that the researchers didn't work for OFII. Domain 2: Study design Theoretical framework 9. What methodological orientation was stated to underpin the study?
Phenomenological study using grounded theory analysis.

Participant selection
10. How were the participants selected? All adult participants who agreed to participate and understood the study goals were selected. 11. How were the participants approached?
Two different approaches were used, depending on the OFII centre in which the study was carried out. The two approaches are described in the methodology section.
12. How many participants were in the study? There are 34 participants in the study.
13. How many participants refused to participate or dropped out? Why?
Two participants explicitly refused to take part in interviews.
Reasons are detailed in the results section of the article. Setting 14. Where was the data collected?
The interviews were carried out in a private space in an OFII centre. 15. Was anyone else present besides the participants and researcher?
Some interviews were conducted with two researchers.
16. What are the important characteristics of the sample?
Participants are a diverse sample of migrants undertaking the medical check-up at OFII Data collection 17. Were questions, prompts, guides provided by the author?
Was it pilot tested?
The questions were asked following an interview guide. The interview guide was prepared in the whole team. It was pilot tested then adjusted.

Were repeat interviews carried out? Details
No repeat interviews were carried out.
19. Did the researcher use audio or visual recording to collect the data?
All interviews were audio recorded with the consent of the participants. 20. Were field notes made during and/or after the interview or focus group?
Notes were taken during interviews.

What was the duration of interviews or focus groups?
The interviews lasted between 6 and 45 minutes, with an average of 15 minutes.
22. Was data saturation discussed? Data saturation was discussed with the entire team of researchers. 23. Were transcripts returned to participants for comments and/or correction?
No transcripts were returned to participants.

Data analysis
24. How many data coders coded the data?
The original coding tree was created with the entire team of researchers. Then, two researchers (IBN and SB) independently coded the transcripts.

Did authors provide a description of the coding tree?
The coding tree is not described.
26. Were themes identified in advance or derived from the data?
Themes were derived from data.
27. What software, if applicable, was used to manage the data?
Researchers coded using the NVivo 10 software.
28. Did participants provide feedback on the findings? The participants didn't provide feedback on the findings.

29.
Were participant quotations presented to illustrate the themes/findings? Was each quotation identified?
Some participants quote are added to illustrate findings.
30. Was there consistency between the data presented and the findings?
The data presented and the findings are consistent.
31. Were major themes clearly presented in the findings?
The major themes are presented in the findings.
32. Is there a description of diverse cases or discussion of minor themes?
Minor themes are discussed.