Sexual Health, HIV Care and Pre-exposure Prophylaxis in the African Immigrant Population: A Needs Assessment

J Immigr Minor Health. 2020 Feb;22(1):134-144. doi: 10.1007/s10903-019-00873-x.

Abstract

The objective was to gain insight, from the perspective of healthcare professionals, non-medical service providers and community-based organizations working with a large majority of African immigrant patients or clients, regarding sexual health and the potential for the use of HIV PrEP in this priority population. Thirty key informants participated in a needs assessment. A questionnaire was used to obtain information through focus groups, structured interviews and by self-administration. There are cultural and linguistic barriers to engaging Africans in discussing sexual health issues. Key challenges to uptake of PrEP are multi-dimensional: socioeconomic [immigration status, housing]; cultural [talking about sex 'taboo', HIV related stigma, no concept of preventive care]; provider-related (cultural competency, inadequate PrEP education, language barrier); and individual (lack of awareness, perception of HIV risk). Meeting basic needs like housing, assuring access to care (including PrEP), community-based education, relevant training of providers, and tailored messaging are strongly recommended. Effectively addressing HIV incidence in the African-born immigrant population redonequires a multi-pronged approach.

Keywords: African-born immigrants; HIV pre-exposure prophylaxis; HIV/AIDS; Sexual health.

MeSH terms

  • Cultural Characteristics
  • Emigrants and Immigrants / statistics & numerical data*
  • Female
  • Focus Groups
  • HIV Infections / drug therapy*
  • HIV Infections / ethnology
  • HIV Infections / prevention & control*
  • Health Knowledge, Attitudes, Practice / ethnology
  • Humans
  • Male
  • Needs Assessment
  • Patient Acceptance of Health Care / ethnology
  • Pre-Exposure Prophylaxis / statistics & numerical data*
  • Sexual Behavior
  • Sexual Health / ethnology*
  • Social Stigma
  • Socioeconomic Factors