ABSTRACT
AIM: To demonstrate the differences between objective and operational knowledges of HIV transmission and care in Black African migrants, and how these differences may be managed in a clinical interview. METHOD: This two phase national New Zealand study first estimated the resident Black African migrant population and HIV seroprevalence. The second phase collected surveys (n=703); focus groups (n=131 people) amplified the survey data. Community advisory groups comprising community leaders and people living with HIV were consulted throughout the study. RESULTS: Black African migrants reported good levels of basic knowledge of HIV on the survey, but demonstrated a range of culturally constructed beliefs and operational knowledge in focus groups. CONCLUSION: Study findings suggest that objective knowledge assessment is not sufficient, and that a contextual approach to understanding what people 'know' is essential, not only for HIV, but for the delivery of all health care education and interventions to Black African new settlers. Routine HIV education and testing, together with staff education, may increase acceptance of these interventions.
Subject(s)
Black People/psychology , Emigrants and Immigrants/statistics & numerical data , HIV Infections/ethnology , HIV Infections/psychology , Health Knowledge, Attitudes, Practice/ethnology , Africa/ethnology , Female , Humans , Male , New Zealand/epidemiology , Risk Factors , Social Stigma , Surveys and QuestionnairesABSTRACT
OBJECTIVE: The AfricaNZ Health project aimed explore HIV risks in Black African communities in NZ with a view to informing HIV infection prevention and health promotion programs. METHODS: AfricaNZ Health was completed in two phases. The first developed desk estimates of the resident Black African population in New Zealand, and Africans living with HIV. The second comprised two arms: an anonymous survey administered at African community events and a series of focus groups around the country. RESULTS: High levels of knowledge and positive attitudes about HIV were more often found in older than younger age groups. Condom use was higher in the younger group than in older age groups. Traditional attitudes still inform some beliefs about HIV. Stigma about HIV and anyone at risk for HIV remains very high among Africans. Western sexual identity constructs are not meaningful. CONCLUSIONS: A culturally informed strategy for risk and stigma reduction is urgently needed. IMPLICATIONS: The existing prevention and care infrastructure, informed by MSM experiences, must address increased risk to Black African new settlers, but this is not a reason to discriminate or further stigmatise an already vulnerable population.