Background: Client satisfaction with HIV service delivery reflects the ability of healthcare providers to effectively deliver care and treatment that meets the requirements and expectations of clients, and is associated with improved health outcomes, including increased retention in care and HIV viral suppression. The aim of the study was to conduct a client satisfaction study among PLHIV attending a large HIV clinic in Trinidad to identify the gaps in service delivery and factors associated with reduced HIV viral suppression. Methods: This cross-sectional study was conducted over the period April 2023–March 2024 among 362 clients attending the HIV clinic. A structured, pre-tested questionnaire collected demographic data and factors that affected client clinic experiences, including wait time, communication with staff, confidentiality, physical amenities and HIV viral suppression. Multivariable logistic regression was used to assess the likelihood of reporting satisfaction based on key independent variables. Results: Among participants, 219 (60.5%) were females, 202 (55.8%) were aged 30–49 years and 337 (93.1%) were virally suppressed. Participants reported satisfaction with overall care (95.3%), confidentiality (95.9%) and interactions with doctors (96.1%), nurses (98.6%) and other staff. Dissatisfaction was reported with facility-related, elements including the outdoor/tented waiting area (46.1%), the toilet/washrooms (37.0%) and the clinic wait time (31.8%). Participants were less likely to be satisfied with the amount of medication received if they had unsuppressed viral loads (p = 0.035), were aged 20–29 years old (p = 0.048) or had a tertiary education (p = 0.008). Conclusions: The study showed that 93.1% of the study participants were virally suppressed, and there was a general level of satisfaction with the overall care at the clinic, confidentiality and healthcare workers’ service delivery; however, gaps involving the physical facilities, wait times and medication services should be prioritized.

Background: Globally, Caribbean countries are among the most heavily burdened by both human immunodeficiency virus and cancer. Due to their immunocompromised status, people living with human immunodeficiency virus (PLWH) are more susceptible to human papillomavirus (HPV)–related cancers. Methods: We conducted a preliminary study evaluating HPV vaccination rates targeting PLWH in Trinidad and Tobago using data from local clinics. This study provided descriptive analysis results, including demographic characteristics of enrolled PLWH and HPV vaccination rates. Results: A total of 5,615 PLWH (age ranged from 18 to 51 years, with 51.4% women and 48.6% men) were enrolled in this evaluation. Of these, 1,178 patients (21.0%) received HPV vaccines: 22.8% were vaccinated with one dose, 25.6% were vaccinated with two doses, and 51.6% were vaccinated with three doses. The highest uptake of 22.3% was in 2021, followed by 20.1% in 2022, but in 2023, it dropped to 15.5%. Between 2018 and 2020, the uptakes were 13.6% for 2020, 12.7% for 2019, and 5.7% for 2018. Conclusions: Overall, the HPV vaccination rates among PLWH in Trinidad and Tobago are low; only one in five was vaccinated. Impact: Results suggest that by implementing comprehensive and targeted programs, clinics have the potential to successfully implement HPV vaccinations toward significantly reducing the incidence and mortality of HPV-related cancers and saving lives. There is a trend with the highest vaccination uptake during the peak years of COVID-19 vaccinations, with HPV vaccination rates almost doubling between 2019 and 2021. Hence, our data suggest that the COVID-19 vaccination program may have boosted HPV vaccination.

HIV-1, Hepatitis B and HTLV-1 have similar risk factors and shared routes of transmission and MSM are disproportionately affected by HIV. The aim of the study was to determine the prevalence of HTLV-1 and HBsAg positivity at initial enrolment among MSM attending a large HIV Clinic in Trinidad. Chart reviews were conducted between 2 and 15 January 2024, among self-identified MSM and a comparative group of randomly selected self-identified heterosexual males where sociodemographic, clinical and laboratory data were collected and analysed using SPSS Version 25. During the period April 2002–31 October 2023, in total there were 10,424 patients registered at the clinic, of whom 1255 (12.0%) were self-identified MSM, with an age range of 19–85 years and a median age of 40 years. There were 1822 randomly selected heterosexual males, with an age range of 18–94 years old and a median age of 52 years. Among the MSM, there were 21 (1.67%) patients who were HIV-1/HTLV-1-coinfected, 64 (5.10%) who were HIV-1/HBsAg-coinfected and two (0.16%) who were coinfected with all three viruses (HIV-1/HTLV-1/HBsAg) as compared to 47 ((2.58%) HIV-1/HTLV-1-coinfected (p = 0.12), 69 (3.79%) HIV-1/HBsAg-coinfected (p = 0.10) and three (0.16%) patients coinfected with all three viruses among the heterosexual males. There were no patients with HTLV-1-related diseases among the HIV-1/HTLV-1-coinfected patients and there were no deaths from chronic liver disease in patients coinfected with HIV-1/HBsAg. Despite the availability of an efficacious vaccine, there is a prevalence of hepatitis B of 5.1% among MSM attending the HIV Clinic in Trinidad; therefore, programmes to increase health literacy, screening and immunization are urgently needed.