Barriers for uptake of COVID antivirals in multicultural communities – Exploring health service provider’s reflections on inequities

Timely access to COVID-19 antivirals is essential for high-risk populations; however, access remains inequitable for many multicultural communities. This study aims to capture the perspectives and experiences of frontline and multicultural support workers on barriers and enablers to antiviral access for members of multicultural communities in New South Wales (NSW) during COVID-19. We conducted three focus groups with 13 frontline and multicultural support workers employed by NSW Health in three local health districts between February and April 2025 to capture participants’ reflections on the 2022 COVID antiviral rollout. During the pandemic, all participants highlighted the extensive and rapid provision of information related to vaccination. In comparison, they received little information and had limited awareness about the rollout of COVID antivirals. Emerging barriers were identified, such as no training on antivirals for multicultural support workers, health system strain from COVID fatigue, and a lack of community trust in novel medications. Trusted relationships within the community were recognised as a key enabling factor in facilitating access to health information during the public health emergency. Persistent health inequities are evident in how multicultural communities were supported to access antivirals, even as these groups have experienced disproportionate impacts across multiple dimensions of the pandemic.