Skip to main content
Top
Published in: International Journal for Equity in Health 1/2018

Open Access 01-12-2018 | Research

Exploring HIV risks, testing and prevention among sub-Saharan African community members in Australia

Authors: Amy B. Mullens, Jennifer Kelly, Joseph Debattista, Tania M. Phillips, Zhihong Gu, Fungisai Siggins

Published in: International Journal for Equity in Health | Issue 1/2018

Login to get access

Abstract

Background

Significant health disparities persist regarding new and late Human Immunodeficiency Virus (HIV) diagnoses among sub-Saharan African (SSA) communities in Australia. Personal/cultural beliefs and practices influence HIV (risk, prevention, testing) within Australia and during visits to home countries.

Method

A community forum was conducted involving 23 male and female adult African community workers, members and leaders, and health workers; facilitated by cultural workers and an experienced clinician/researcher. The forum comprised small/large group discussions regarding HIV risk/prevention (responses transcribed verbatim; utilising thematic analysis).

Results

Stigma, denial, social norms, tradition and culture permeated perceptions/beliefs regarding HIV testing, prevention and transmission among African Australians, particularly regarding return travel to home countries.

Conclusions

International travel as a risk factor for HIV acquisition requires further examination, as does the role of the doctor in HIV testing and Pre-exposure Prophylaxis (PrEP). Further assessment of PrEP as an appropriate/feasible intervention is needed, with careful attention regarding negative community perceptions and potential impacts.
Literature
1.
go back to reference Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia, Annual surveillance report 2017. UNSW 2017. Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia, Annual surveillance report 2017. UNSW 2017.
2.
go back to reference Fakoya I, Álvarez-del Arco D, Woode-Owusu M, Monge S, Rivero-Montesdeoca Y, Delpech V, et al. A systematic review of post-migration acquisition of HIV among migrants from countries with generalised HIV epidemics living in Europe: implications for effectively managing HIV prevention programmes and policy. BMC Public Health. 2015;15(1):561.CrossRefPubMedPubMedCentral Fakoya I, Álvarez-del Arco D, Woode-Owusu M, Monge S, Rivero-Montesdeoca Y, Delpech V, et al. A systematic review of post-migration acquisition of HIV among migrants from countries with generalised HIV epidemics living in Europe: implications for effectively managing HIV prevention programmes and policy. BMC Public Health. 2015;15(1):561.CrossRefPubMedPubMedCentral
3.
go back to reference Kramer MA, van Veen MG, de Coul EL, Geskus RB, Coutinho RA, van de Laar MJW, et al. Migrants travelling to their country of origin: a bridge population for HIV transmission? Sex Transm Infect. 2008;84(7):554–5.CrossRefPubMed Kramer MA, van Veen MG, de Coul EL, Geskus RB, Coutinho RA, van de Laar MJW, et al. Migrants travelling to their country of origin: a bridge population for HIV transmission? Sex Transm Infect. 2008;84(7):554–5.CrossRefPubMed
4.
go back to reference Okoro ON, Whitson SO. HIV risk and barriers to care for African-born immigrant women: a sociocultural outlook. Int J Womens Health. 2017:421–9. Okoro ON, Whitson SO. HIV risk and barriers to care for African-born immigrant women: a sociocultural outlook. Int J Womens Health. 2017:421–9.
5.
go back to reference Lemoh C, Biggs BA, Hellard M. Working with west African migrant communities on HIV prevention in Australia. Sex Health. 2008;5(4):313–4.CrossRefPubMed Lemoh C, Biggs BA, Hellard M. Working with west African migrant communities on HIV prevention in Australia. Sex Health. 2008;5(4):313–4.CrossRefPubMed
6.
go back to reference Australian Department of Health. Seventh National HIV Strategy 2014–2017. Australian Department of Health. Seventh National HIV Strategy 2014–2017.
7.
go back to reference Uwah C, Ebewo P. Culture and HIV/AIDS: analysis of the perception of culture and HIV/AIDS prevalence in southern Africa. J Arts Manage Law Soc. 2011;41(3):198–211.CrossRef Uwah C, Ebewo P. Culture and HIV/AIDS: analysis of the perception of culture and HIV/AIDS prevalence in southern Africa. J Arts Manage Law Soc. 2011;41(3):198–211.CrossRef
8.
go back to reference Hawke KG, Waddell RG, Gordon DL, Ratcliff RM, Ward PR, Kaldor JM. HIV non-B subtype distribution: emerging trends and risk factors for imported and local infections newly diagnosed in South Australia. AIDS Res Hum Retrovir. 2013;29(2):311.PubMedCrossRef Hawke KG, Waddell RG, Gordon DL, Ratcliff RM, Ward PR, Kaldor JM. HIV non-B subtype distribution: emerging trends and risk factors for imported and local infections newly diagnosed in South Australia. AIDS Res Hum Retrovir. 2013;29(2):311.PubMedCrossRef
9.
go back to reference Taylor BS, Garduño LS, Reyes EV, Valiño R, Rojas R, Donastorg Y, et al. HIV Care for Geographically Mobile Populations. Mt Sinai J Med. 2011;78(3):342–51.CrossRefPubMedPubMedCentral Taylor BS, Garduño LS, Reyes EV, Valiño R, Rojas R, Donastorg Y, et al. HIV Care for Geographically Mobile Populations. Mt Sinai J Med. 2011;78(3):342–51.CrossRefPubMedPubMedCentral
10.
go back to reference Vissers DCJ, Voeten HACM, Urassa M, Isingo R, Ndege M, Kumogola Y, et al. Separation of spouses due to travel and living apart raises HIV risk in Tanzanian couples. Sex Transm Dis. 2008;35(8):714–20.CrossRefPubMed Vissers DCJ, Voeten HACM, Urassa M, Isingo R, Ndege M, Kumogola Y, et al. Separation of spouses due to travel and living apart raises HIV risk in Tanzanian couples. Sex Transm Dis. 2008;35(8):714–20.CrossRefPubMed
11.
go back to reference Ayikukwei RM, Ngare D, Sidle JE, Ayuku DO, Baliddawa J, Greene JY. Social and cultural significance of the sexual cleansing ritual and its impact on HIV prevention strategies in western Kenya. Sex Cult. 2007;11(3):32–50.CrossRef Ayikukwei RM, Ngare D, Sidle JE, Ayuku DO, Baliddawa J, Greene JY. Social and cultural significance of the sexual cleansing ritual and its impact on HIV prevention strategies in western Kenya. Sex Cult. 2007;11(3):32–50.CrossRef
12.
go back to reference Heus L. ‘There is no love here anyway.’ Sexuality, identity and HIV prevention in an African sub-culture in Amsterdam, the Netherlands. Sex Health. 2010;7(2):129–34.CrossRefPubMed Heus L. ‘There is no love here anyway.’ Sexuality, identity and HIV prevention in an African sub-culture in Amsterdam, the Netherlands. Sex Health. 2010;7(2):129–34.CrossRefPubMed
13.
go back to reference Idoko J, Folayan MO, Dadem NY, Kolawole GO, Anenih J, Alhassan E. “Why should I take drugs for your infection?”: Outcomes of formative research on the use of HIV pre-exposure prophylaxis in Nigeria. BMC Public Health. 2015;15(1):349.CrossRefPubMedPubMedCentral Idoko J, Folayan MO, Dadem NY, Kolawole GO, Anenih J, Alhassan E. “Why should I take drugs for your infection?”: Outcomes of formative research on the use of HIV pre-exposure prophylaxis in Nigeria. BMC Public Health. 2015;15(1):349.CrossRefPubMedPubMedCentral
14.
go back to reference Leclerc-Madlala S. Cultural scripts for multiple and concurrent partnerships in southern Africa: why HIV prevention needs anthropology. Sex Health. 2009;6(2):103–10.CrossRefPubMed Leclerc-Madlala S. Cultural scripts for multiple and concurrent partnerships in southern Africa: why HIV prevention needs anthropology. Sex Health. 2009;6(2):103–10.CrossRefPubMed
15.
go back to reference McCreary LL, Kaponda CPN, Norr KF, Jere DLN, Chipeta CH, Davis KK, et al. Rural Malawians’ perceptions of HIV risk behaviors and their sociocultural context. AIDS Care. 2008;20(8):946–57.CrossRefPubMed McCreary LL, Kaponda CPN, Norr KF, Jere DLN, Chipeta CH, Davis KK, et al. Rural Malawians’ perceptions of HIV risk behaviors and their sociocultural context. AIDS Care. 2008;20(8):946–57.CrossRefPubMed
16.
go back to reference Tenkorang EY, Gyimah SO, Maticka-Tyndale E, Adjei J. Superstition, witchcraft and HIV prevention in sub-Saharan Africa: the case of Ghana. Cult Health Sex. 2011;13(9):1001–14.CrossRefPubMed Tenkorang EY, Gyimah SO, Maticka-Tyndale E, Adjei J. Superstition, witchcraft and HIV prevention in sub-Saharan Africa: the case of Ghana. Cult Health Sex. 2011;13(9):1001–14.CrossRefPubMed
17.
go back to reference Mah TL, Halperin DT. Concurrent sexual partnerships and the HIV epidemics in Africa: evidence to move forward. AIDS Behav. 2010;14(1):11–6.CrossRefPubMed Mah TL, Halperin DT. Concurrent sexual partnerships and the HIV epidemics in Africa: evidence to move forward. AIDS Behav. 2010;14(1):11–6.CrossRefPubMed
18.
go back to reference Mah TL, Halperin DT. The evidence for the role of concurrent partnerships in Africa’s HIV epidemics: a response to Lurie and Rosenthal. AIDS Behav. 2010;14(1):25–8.CrossRef Mah TL, Halperin DT. The evidence for the role of concurrent partnerships in Africa’s HIV epidemics: a response to Lurie and Rosenthal. AIDS Behav. 2010;14(1):25–8.CrossRef
19.
go back to reference Inungu J, Karl S. Understanding the scourge of HIV/AIDS in sub-Saharan Africa. J Int AIDS Soc. 2006;1(1):30.CrossRef Inungu J, Karl S. Understanding the scourge of HIV/AIDS in sub-Saharan Africa. J Int AIDS Soc. 2006;1(1):30.CrossRef
21.
go back to reference Xiridou M, van Veen M, Coutinho R, Prins M. Can migrants from high-endemic countries cause new HIV outbreaks among heterosexuals in low-endemic countries? AIDS. 2010;24(13):2081–8.CrossRefPubMed Xiridou M, van Veen M, Coutinho R, Prins M. Can migrants from high-endemic countries cause new HIV outbreaks among heterosexuals in low-endemic countries? AIDS. 2010;24(13):2081–8.CrossRefPubMed
23.
go back to reference Oluga M, Kiragu S, Mohamed MK, Walli S. ‘Deceptive’ cultural practices that sabotage HIV/AIDS education in Tanzania and Kenya. J Moral Educ. 2010;39(3):365–80.CrossRef Oluga M, Kiragu S, Mohamed MK, Walli S. ‘Deceptive’ cultural practices that sabotage HIV/AIDS education in Tanzania and Kenya. J Moral Educ. 2010;39(3):365–80.CrossRef
24.
go back to reference Mack N, Odhiambo J, Wong CM, Agot K. Barriers and facilitators to pre-exposure prophylaxis (PrEP) eligibility screening and ongoing HIV testing among target populations in Bondo and Rarieda, Kenya: results of a consultation with community stakeholders. BMC Health Serv Res. 2014;14(1):231.CrossRefPubMedPubMedCentral Mack N, Odhiambo J, Wong CM, Agot K. Barriers and facilitators to pre-exposure prophylaxis (PrEP) eligibility screening and ongoing HIV testing among target populations in Bondo and Rarieda, Kenya: results of a consultation with community stakeholders. BMC Health Serv Res. 2014;14(1):231.CrossRefPubMedPubMedCentral
25.
go back to reference Nyanzi S, Nassimbwa J, Kayizzi V, Kabanda S. ‘African sex is dangerous!’ Renegotiating ‘ritual sex’ in contemporary Masaka District. Afr. 2008;78(4):518–39.CrossRef Nyanzi S, Nassimbwa J, Kayizzi V, Kabanda S. ‘African sex is dangerous!’ Renegotiating ‘ritual sex’ in contemporary Masaka District. Afr. 2008;78(4):518–39.CrossRef
26.
go back to reference Moyo N, Müller JC. The influence of cultural practices on the HIV and AIDS pandemic in Zambia. Theol Stud. 2011;67(3):1–5.CrossRef Moyo N, Müller JC. The influence of cultural practices on the HIV and AIDS pandemic in Zambia. Theol Stud. 2011;67(3):1–5.CrossRef
27.
go back to reference Peters E, Brewer D, Udonwa N, Jombo G, Essien O, Umoh V, et al. Diverse blood exposures associated with incident HIV infection in Calabar, Nigeria. Int J STD AIDS. 2009;20(12):846–51.CrossRefPubMed Peters E, Brewer D, Udonwa N, Jombo G, Essien O, Umoh V, et al. Diverse blood exposures associated with incident HIV infection in Calabar, Nigeria. Int J STD AIDS. 2009;20(12):846–51.CrossRefPubMed
29.
go back to reference Grebe E, Nattrass N. AIDS conspiracy beliefs and unsafe sex in cape town. AIDS Behav. 2012;16(3):761–73.CrossRefPubMed Grebe E, Nattrass N. AIDS conspiracy beliefs and unsafe sex in cape town. AIDS Behav. 2012;16(3):761–73.CrossRefPubMed
30.
go back to reference Drummond PD, Mizan A, Wright B. HIV/AIDS knowledge and attitudes among west African immigrant women in Western Australia. Sex Health. 2008;5(3):251–9.CrossRefPubMed Drummond PD, Mizan A, Wright B. HIV/AIDS knowledge and attitudes among west African immigrant women in Western Australia. Sex Health. 2008;5(3):251–9.CrossRefPubMed
32.
go back to reference Jiang J, Yang X, Ye L, Zhou B, Ning C, Huang J, et al. Pre-exposure prophylaxis for the prevention of HIV infection in high risk populations: a meta-analysis of randomized controlled trials. PLoS One. 2014;9(2):e87674.CrossRefPubMedPubMedCentral Jiang J, Yang X, Ye L, Zhou B, Ning C, Huang J, et al. Pre-exposure prophylaxis for the prevention of HIV infection in high risk populations: a meta-analysis of randomized controlled trials. PLoS One. 2014;9(2):e87674.CrossRefPubMedPubMedCentral
33.
go back to reference Nikolopoulos GK, Christaki E, Paraskevis D, Bonovas S. Pre-exposure prophylaxis for HIV: evidence and perspectives. Curr Pharm Des. 2017;23(18):2579–91.PubMed Nikolopoulos GK, Christaki E, Paraskevis D, Bonovas S. Pre-exposure prophylaxis for HIV: evidence and perspectives. Curr Pharm Des. 2017;23(18):2579–91.PubMed
36.
go back to reference Golub SA, Gamarel KE, Rendina HJ, Surace A, Lelutiu-Weinberger CL. From efficacy to effectiveness: facilitators and barriers to PrEP acceptability and motivations for adherence among MSM and transgender women in New York City. AIDS Patient Care STDs. 2013;27(4):248–54.CrossRefPubMedPubMedCentral Golub SA, Gamarel KE, Rendina HJ, Surace A, Lelutiu-Weinberger CL. From efficacy to effectiveness: facilitators and barriers to PrEP acceptability and motivations for adherence among MSM and transgender women in New York City. AIDS Patient Care STDs. 2013;27(4):248–54.CrossRefPubMedPubMedCentral
37.
go back to reference Sandelowski M. Focus on research methods-Whatever happened to qualitative description? Res Nurs Health. 2000;23(4):334–40.CrossRefPubMed Sandelowski M. Focus on research methods-Whatever happened to qualitative description? Res Nurs Health. 2000;23(4):334–40.CrossRefPubMed
38.
go back to reference Lambert VA, Lambert CE. Qualitative descriptive research: an acceptable design. Pac rim Int J Nurs Res. 2012;16(4):255–6. Lambert VA, Lambert CE. Qualitative descriptive research: an acceptable design. Pac rim Int J Nurs Res. 2012;16(4):255–6.
39.
go back to reference Liamputtong P. Research methods in health: foundations evidence-based practice. 2nd ed. South Melbourne: Oxford University Press; 2013. Liamputtong P. Research methods in health: foundations evidence-based practice. 2nd ed. South Melbourne: Oxford University Press; 2013.
40.
go back to reference Liamputtong P. Qualitative research methods. 4th ed. South Melbourne: Oxford University Press; 2013. Liamputtong P. Qualitative research methods. 4th ed. South Melbourne: Oxford University Press; 2013.
41.
go back to reference c P. The practice of qualitative research. 3rd ed. Boston: Sage Publications; 2011. c P. The practice of qualitative research. 3rd ed. Boston: Sage Publications; 2011.
44.
go back to reference Loos J, Nöstlinger C, Reyniers T, Colebunders R, Jespers V, Manirankunda L, et al. PrEP for African migrants in Europe? A research agenda. Lancet HIV. 2016;3(11):e505–e7.CrossRefPubMed Loos J, Nöstlinger C, Reyniers T, Colebunders R, Jespers V, Manirankunda L, et al. PrEP for African migrants in Europe? A research agenda. Lancet HIV. 2016;3(11):e505–e7.CrossRefPubMed
45.
go back to reference Blondell SJ, Kitter B, Griffin MP, Durham J. Barriers and facilitators to HIV testing in migrants in high-income countries: a systematic review. AIDS Behav. 2015;19(11):2012–24.CrossRefPubMed Blondell SJ, Kitter B, Griffin MP, Durham J. Barriers and facilitators to HIV testing in migrants in high-income countries: a systematic review. AIDS Behav. 2015;19(11):2012–24.CrossRefPubMed
47.
go back to reference Baidoobonso S, Bauer GR, Speechley KN, Lawson E. HIV risk perception and distribution of HIV risk among African, Caribbean and other black people in a Canadian city: mixed methods results from the BLACCH study. BMC Public Health. 2013;13(1) Baidoobonso S, Bauer GR, Speechley KN, Lawson E. HIV risk perception and distribution of HIV risk among African, Caribbean and other black people in a Canadian city: mixed methods results from the BLACCH study. BMC Public Health. 2013;13(1)
48.
go back to reference Stutterheim SE, Bos AER, van Kesteren NMC, Shiripinda I, Pryor JB, de Bruin M, et al. Beliefs contributing to HIV-related stigma in African and afro-Caribbean communities in the Netherlands. J Community Appl Soc Psychol. 2012;22(6):470–84.CrossRef Stutterheim SE, Bos AER, van Kesteren NMC, Shiripinda I, Pryor JB, de Bruin M, et al. Beliefs contributing to HIV-related stigma in African and afro-Caribbean communities in the Netherlands. J Community Appl Soc Psychol. 2012;22(6):470–84.CrossRef
49.
go back to reference Agu J, Lobo R, Crawford G, Chigwada B. Migrant sexual health help-seeking and experiences of stigmatization and discrimination in Perth, Western Australia: exploring barriers and enablers. Int J Environ Res Public Health. 2016;13(5):485. Agu J, Lobo R, Crawford G, Chigwada B. Migrant sexual health help-seeking and experiences of stigmatization and discrimination in Perth, Western Australia: exploring barriers and enablers. Int J Environ Res Public Health. 2016;13(5):485.
50.
go back to reference Manirankunda L, Loos J, Alou TA, Colebunders R, Nöstlinger C. It's better not to know': perceived barriers to HIV voluntary counseling and testing among sub-Saharan African migrants in Belgium. AIDS Educ Prev. 2009;21(6):582–93.CrossRefPubMed Manirankunda L, Loos J, Alou TA, Colebunders R, Nöstlinger C. It's better not to know': perceived barriers to HIV voluntary counseling and testing among sub-Saharan African migrants in Belgium. AIDS Educ Prev. 2009;21(6):582–93.CrossRefPubMed
51.
go back to reference Korner H. HIV and migration: two major uncertainties for people from culturally and linguistically diverse backgrounds. Sydney: National Centre in HIV Social Research; 2005. Korner H. HIV and migration: two major uncertainties for people from culturally and linguistically diverse backgrounds. Sydney: National Centre in HIV Social Research; 2005.
52.
go back to reference Van Der Straten A, Stadler J, Montgomery E, Hartmann M, Magazi B, Mathebula F, et al. Women's experiences with oral and vaginal pre-exposure prophylaxis: the VOICE-C qualitative study in Johannesburg, South Africa. PLoS One. 2014;9(2):e89118.CrossRefPubMedPubMedCentral Van Der Straten A, Stadler J, Montgomery E, Hartmann M, Magazi B, Mathebula F, et al. Women's experiences with oral and vaginal pre-exposure prophylaxis: the VOICE-C qualitative study in Johannesburg, South Africa. PLoS One. 2014;9(2):e89118.CrossRefPubMedPubMedCentral
53.
go back to reference Geissler PW, Pool R. Popular concerns about medical research projects in sub-Saharan Africa–a critical voice in debates about medical research ethics. Tropical Med Int Health. 2006;11(7):975–82.CrossRef Geissler PW, Pool R. Popular concerns about medical research projects in sub-Saharan Africa–a critical voice in debates about medical research ethics. Tropical Med Int Health. 2006;11(7):975–82.CrossRef
54.
go back to reference Monjok E, Essien EJ, Holmes L. Female genital mutilation: potential for HIV transmission in sub-Saharan Africa and prospect for epidemiologic investigation and intervention. Afr J Reprod Health. 2007;11(1):33–42.CrossRefPubMed Monjok E, Essien EJ, Holmes L. Female genital mutilation: potential for HIV transmission in sub-Saharan Africa and prospect for epidemiologic investigation and intervention. Afr J Reprod Health. 2007;11(1):33–42.CrossRefPubMed
55.
go back to reference Zungu N, Simbayi L, Mabaso M, Evans M, Zuma K, Ncitakalo N, et al. HIV risk perception and behavior among medically and traditionally circumcised males in South Africa. BMC Public Health. 2016;16(1):357.CrossRefPubMedPubMedCentral Zungu N, Simbayi L, Mabaso M, Evans M, Zuma K, Ncitakalo N, et al. HIV risk perception and behavior among medically and traditionally circumcised males in South Africa. BMC Public Health. 2016;16(1):357.CrossRefPubMedPubMedCentral
56.
go back to reference Reniers G, Tfaily R. Polygyny, partnership concurrency, and HIV transmission in sub-Saharan Africa. Demography. 2012;49(3):1075–101.CrossRefPubMed Reniers G, Tfaily R. Polygyny, partnership concurrency, and HIV transmission in sub-Saharan Africa. Demography. 2012;49(3):1075–101.CrossRefPubMed
57.
go back to reference Kay M, Jackson C, Nicholson C. Refugee health: a new model for delivering primary health care. Aust J Prim Health. 2010;16(1):98–103.CrossRefPubMed Kay M, Jackson C, Nicholson C. Refugee health: a new model for delivering primary health care. Aust J Prim Health. 2010;16(1):98–103.CrossRefPubMed
Metadata
Title
Exploring HIV risks, testing and prevention among sub-Saharan African community members in Australia
Authors
Amy B. Mullens
Jennifer Kelly
Joseph Debattista
Tania M. Phillips
Zhihong Gu
Fungisai Siggins
Publication date
01-12-2018
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2018
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-018-0772-6

Other articles of this Issue 1/2018

International Journal for Equity in Health 1/2018 Go to the issue