Delivery of the women-centred HIV care model in Canadian HIV clinics: an environmental scan.

The Women-Centred HIV Care (WCHC) Model addresses women living with HIV's multifaceted healthcare needs, but its delivery remains unclear. This environmental scan examines the delivery of the WCHC Model in Canadian HIV clinics. Clinics were surveyed on health service delivery, then scored out of 10 in the six domains of the WCHC Model using a service-based score system. Generally, on-site services were assigned more value than off-site referrals. Of 59 clinics, 35 (59%) were surveyed, representing all Canadian regions except Alberta, Northwest Territories and Nunavut. The highest scoring domains were HIV care (median [interquartile range] 9.3 [8.6-9.9]) and sexual health care (9.0 [7.0-10.0]), while the peer support/leadership/capacity building domain scored lowest (2.1 [0.0-5.3]). Scores varied between regions in trauma/violence-aware care (7.5 [1.3-10.0]), person-centred care (6.7 [5.0-10.0]), women's healthcare (7.5 [6.3-8.8]) and mental health/addiction care (6.7 [5.0-8.3]). On-site mental health and addiction services were largely unavailable. Our findings demonstrate that WCHC Model delivery varies between regions, with Canada-wide strengths in HIV and sexual health care. Increasing the availability of peer support/leadership/capacity building opportunities and on-site mental health and addiction services at HIV clinics would enhance comprehensive care for women living with HIV.