1. Impact of HIV knowledge and stigma on the uptake of HIV testing – Results from a community-based participatory research survey among migrants from sub-Saharan Africa in Germany
- Author
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Virginia Wangare Greiner, Stephen K. Amoah, Helene Batemona-Abeke, Johanna Müllerschön, Viviane Bremer, Taty Dela Bursi, Pierre Mayamba, Claudia Santos-Hövener, Carmen Koschollek, A Thorlie, Anna Kuehne, and Christina Mputu Tshibadi
- Subjects
RNA viruses ,Male ,Health Knowledge, Attitudes, Practice ,Social stigma ,Cross-sectional study ,Economics ,Epidemiology ,Social Stigma ,Psychological intervention ,lcsh:Medicine ,Social Sciences ,HIV Infections ,Pathology and Laboratory Medicine ,Geographical locations ,Cultural Anthropology ,0302 clinical medicine ,Immunodeficiency Viruses ,Sociology ,Germany ,Surveys and Questionnaires ,Medicine and Health Sciences ,Medicine ,030212 general & internal medicine ,Young adult ,lcsh:Science ,Transients and Migrants ,Multidisciplinary ,virus diseases ,HIV diagnosis and management ,Middle Aged ,Europe ,Religion ,Medical Microbiology ,HIV epidemiology ,Viral Pathogens ,Viruses ,Infectious diseases ,Female ,Pathogens ,0305 other medical science ,Attitude to Health ,Research Article ,Adult ,Community-Based Participatory Research ,Adolescent ,Sexual Behavior ,HIV prevention ,MEDLINE ,Community-based participatory research ,Participatory action research ,Emigrants and Immigrants ,Viral diseases ,Microbiology ,Odds ,03 medical and health sciences ,Young Adult ,Health Economics ,Risk-Taking ,Patient Education as Topic ,Retroviruses ,Humans ,European Union ,Microbial Pathogens ,Africa South of the Sahara ,Aged ,Preventive medicine ,030505 public health ,business.industry ,lcsh:R ,Lentivirus ,Organisms ,Biology and Life Sciences ,HIV ,Diagnostic medicine ,Health Care ,Public and occupational health ,Cross-Sectional Studies ,Anthropology ,Sample Size ,lcsh:Q ,People and places ,business ,Demography ,Health Insurance - Abstract
Background In 2015, 3,674 new HIV diagnoses were notified in Germany; 16% of those newly diagnosed cases originated from sub-Saharan Africa (sSA). One quarter of the newly diagnosed cases among migrants from sSA (MisSA) are notified as having acquired the HIV infection in Germany. In order to reach MisSA with HIV testing opportunities, we aimed to identify which determinants influence the uptake of HIV testing among MisSA in Germany. Methods To identify those determinants, we conducted a quantitative cross-sectional survey among MisSA in Germany. The survey was designed in a participatory process that included MisSA and other stakeholders in HIV-prevention. Peer researchers recruited participants to complete standardized questionnaires on HIV knowledge and testing. We conducted multivariable analyses (MVA) to identify determinants associated with ever having attended voluntary HIV testing; and another MVA to identify determinant associated with having had the last voluntary HIV test in Germany. Results Peer researchers recruited 2,782 participants eligible for inclusion in the MVA. Of these participants, 59.9% (1,667/2,782) previously had an HIV test. For each general statement about HIV that participants knew prior to participation in the study, the odds of having been tested increased by 19% (OR 1.19; 95%-CI: 1.11-1.27). Participants reporting that HIV is a topic that is discussed in their community had 92% higher odds of having been tested for HIV (OR 1.92; 95%-CI: 1.60-2.31). Migrants living in Germany for less than a year had the lowest odds of having had their last HIV test in Germany (OR 0.17; 95%-CI: 0.11-0.27). Additionally, MisSA 18 to 25 years (OR 0.55; 95%-CI: 0.42-0.73) and participants with varied sexual partners and inconsistent condom use (OR 0.75; 95%-CI: 0.44-0.97) had significantly lower odds of having had their last HIV test in Germany. Discussion Through participatory research, we were able to show that knowledge about HIV and discussing HIV in communities increased the odds of having attended HIV testing among MisSA. However, recent migrants and young sexually active people are among the least reached by testing offers in Germany. Community-based interventions may present opportunities to reach such migrants and improve knowledge and increase discussion about HIV.
- Published
- 2018