Qualitatively-Driven Mixed-Methods Health Research Protocol: “HIV/STBBIs in a Post-Pandemic World: Challenges and Opportunities for Addressing the Needs of People Living With HIV”

This qualitatively-driven, mixed-methods study explores the impacts of the COVID-19 pandemic on people living with human immunodeficiency virus (HIV) testing, treatment, and linkage to care in Manitoba, Canada. Building on the “Landscape of Risk” study, a population-level quantitative analysis examining associations between COVID-19 vaccination and HIV/sexually transmitted and blood borne infection (STBBI) testing, this protocol describes the qualitative phase designed to contextualize those findings. Preliminary data suggests that people living with HIV (PLWHIV) were more likely to receive COVID-19 vaccinations than the general population while also being more likely to acquire the virus. This contrasts with lower vaccination rates among other STBBI-affected cohorts, raising critical questions about health system engagement, trust, and access. Through interviews and focus groups with both PLWHIV and health care service providers, this study aims to validate quantitative results, explore pandemic-era shifts in HIV/STBBI service use, and generate recommendations for improving health equity in future pandemic responses. Guided by constructivist, critical, and poststructuralist paradigms, and informed by ethical, community-based research principles, the study uses a sequential exploratory design to integrate community narratives with administrative health data. Data will be collected in partnership with Nine Circles Community Health Centre and analyzed using thematic analysis. This study’s commitment to rigor, reflexivity, and participant voice ensures relevance to public health policy, while offering insights into resilience, service adaptations, and equity-oriented strategies for vulnerable populations navigating intersecting health risks in a post-pandemic world.