Harambee! 2.0: The Impact of HIV-Related and Intersectional Stigmas on HIV Testing Behaviors Among African Immigrant Communities in Seattle, Washington

Abstract

African immigrants are disproportionately affected by HIV compared to U.S.-born individuals, and early HIV testing is the key challenge in ending the HIV epidemic in these communities. HIV-related stigma appears to be the most significant barrier to testing for HIV among African communities in King County, WA. In this formative study, we conducted thirty key informant interviews and five focus group discussions (n = total 72 participants) with Ethiopian, Somali, and Eritrean people living with HIV, health professionals, religious and other community leaders, and lay community members in King County to better understand HIV-related and intersectional stigmas’ impact on HIV testing behaviors. We used inductive coding and thematic analysis. Participants from all communities reported similar themes for HIV-related and intersectional stigmas’ influences on HIV testing behaviors. Misconceptions or poor messaging, e.g., regarding treatability of HIV, as well as normative or religious/moral beliefs around pre/extramarital sex contributed to HIV-related stigma. Intersecting identities such as immigrant status, race/ethnicity, and having a non-English language preference, all intermingle to further influence access to the U.S. healthcare system, including for HIV testing. These findings can be used to inform future research on community-led approaches to addressing early HIV testing amongst African immigrant communities. Supplementary Information The online version contains supplementary material available at 10.1007/s10461-021-03396-5.

Social stigmas towards people living with HIV in the Sars-CoV-2 vaccination process

“…The incorporation of gender aspects is another relevant issue in training, where the concept of intersectionality (23) is relevant, considering cultural diversity and processes such as migration, which has been remarkable in recent years in Chile, together with the results of research in which the expression of social stigmas towards people due to race and ethnicity, and/or for identifying themselves as women, have become evident (24,25,26,27) .…”

HIV testing and risk behaviors associated with depression in the United States

“…( Parchem and Molock, 2022 , Zhang et al, 2021 , Wise et al, 2019 ) Other studies identified that demographic characteristics (e.g., age, sex, race/ethnicity, and educational status) might be associated with the HIV testing behaviors. ( Qiao et al, 2018 ) Much of the prior literature focused on HIV testing behaviors among specific populations, such as men who have sex with men, ( Bien-Gund et al, 2022 ) transgender, ( Tordoff et al, 2022 , Pitasi et al, 2020 ) Black racial groups, ( Uzoeghelu et al, 2021 ) youth, ( Haney-Caron et al, 2021 , Phillips et al, 2020 ) or populations from a specific region in the U.S. ( Marshall et al, 2020 , Daniel et al, 2022 ) In addition to these populations, prior studies also focused on people with mental illnesses like depression, demonstrating the potential influence of depression status on HIV testing. ( Senn and Carey, 2009 , Yehia et al, 2014 ) Our study adds to existing literature by focusing on a nationally representative sample of adults with self-reported depression across all demographic factors.…”

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“…É importante entender essas disparidades para direcionar intervenções e políticas de prevenção eficazes e garantir que todas as populações afetadas tenham acesso a cuidados de saúde adequados e apoio (Daniel et al, 2022). Haja vista que a infecção pelo HIV tem uma série de repercussões funcionais e fisiológicas no corpo humano, como na diminuição das células CD4, que são cruciais para o sistema imunológico.…”