Perspectives on Factors Related to HIV Risk and Preventative Interventions at Multiple Levels: A Study of African Immigrant Women Survivors of Cumulative Trauma

Sabri, Bushra

doi:10.1521/aeap.2018.30.5.419

Cited by 13 publications

(7 citation statements)

References 38 publications

(56 reference statements)

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“…This work is most readily transferable to other Ethiopian, Somali, and Eritrean communities in the U.S., and may be limited in applicability to other East African or African immigrant communities. However, given the marked similarities and commonalities that arose in our findings, we anticipate many of our findings will resonate with many African or even other immigrant communities in the U.S. [ 16 , 47 – 49 ]. The subgroups we chose to prioritize, such as PLWH or religious leaders, may not have captured the breath of various perspectives within each community.…”

Section: Discussionmentioning

confidence: 54%

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

et al. 2021

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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.

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Section: Discussionmentioning

confidence: 54%

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

et al. 2021

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“…Research shows that women with histories of violence and trauma are at high risk for HIV infection, irrespective of race or ethnicity (Wyatt et al, 2002). Women with exposures to violence have limited control over HIV risk practices due to their inability to negotiate safer sex with an abusive partner or financial dependence on sexual partners (Sabri, 2018; Wyatt et al, 2002). Thus, pre- and postmigration exposures to violence can place immigrant women at high risk for HIV/STI infection or transmission.…”

Section: Discussionmentioning

confidence: 99%

“…Such experiences in pre- and postmigration context place Black immigrant women at higher risk of various negative health outcomes than other groups (Corley & Sabri, 2021). For example, Black immigrant women from Africa have been found to have significantly higher rates of human immune deficiency virus (HIV) than native-born populations (Blanas et al, 2013; Kerani et al, 2008; Okoro & Whitson, 2017; Sabri, 2018). These findings could be attributed to cumulative exposures to violence (CETV) as well as other postmigration stressors (e.g., acculturative stress, discrimination; Bustamante et al, 2018).…”

Section: Development Of Bshapementioning

confidence: 99%

The being safe, health and positively empowered pilot randomized controlled trial: A digital multicomponent intervention for immigrant women with cumulative exposures to violence.

Sabri,

Perrin,

Hagos

2024

Cultural Diversity & Ethnic Minority Psychology

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Objectives: Pre-and postmigration exposures to violence are significant social determinants of immigrant women's health, safety, and well-being, with Black immigrant women being at high risk because of many coming from conflict-zone countries. The existing literature does not report the development and testing of a multicomponent digital intervention to address safety and health issues among immigrant women with cumulative exposures to violence. This pilot randomized controlled trial evaluated preliminary efficacy of a multicomponent digital intervention (BSHAPE) to improve health and safety outcomes for immigrant women with cumulative violence exposures, posttraumatic stress disorder and/or depression symptoms, and human immune deficiency virus (HIV) risk behaviors. Method: The intervention was developed based on formative qualitative work and input from women. In the randomized controlled trial, 144 Black immigrant women, average age being 33.6 years, were randomly assigned to either the BSHAPE arm (n = 72) or a control arm (n = 72). Data were collected at four time points over 12 months. A generalized estimating equation analysis was performed to examine group differences in change in outcomes over time. Results: Compared to the control arm, participants in BSHAPE showed significant improvement in multiple outcome measures (e.g., HIV/STI risk). Conclusion: This pilot trial of BSHAPE showed promising results for immigrant women with lifetime exposures to violence, poor mental health, and HIV risk. The study also provided useful information to further improve BSHAPE for a full-scale efficacy trial. The digital BSHAPE can be especially advantageous for violence-affected immigrant women who face numerous barriers to accessing in-person care for their safety and health needs. Public Significance StatementMany immigrant women in the United States have dealt with pre-and postmigration exposures to violence and stressors related to intersecting identities of race, ethnicity, gender, and social class, with negative impact on physical and mental health. However, they are unable to access in-person services due to numerous barriers related to family and work responsibilities, transportation, and geographical location. The BSHAPE, a strengths-based and empowerment-focused multicomponent digital intervention, has the potential to address impact of trauma on their lives, reduce stress, enhance coping skills, and provide information about key areas of women's health, resources for support and economic empowerment, as well as about immigration rights, while discussing safety options for those in current abusive relationships.

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“…Such training should also address the fact that the Warao culture conceptualizes diseases as witchcraft or spiritual problems. Cultural factors were also identified as relevant among African immigrants [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Finally, it is important to highlight the Action Plan´s importance both for the city of Manaus and for other areas of Brazil, given that the particularly vulnerable conditions migrants largely determine their health status [ 29 ]. The Action Plan allows mitigating barriers and promoting action aimed at well-being, health promotion, and prevention of diseases, including early diagnosis of infectious diseases such as tuberculosis and HIV.…”

Section: Discussionmentioning

confidence: 99%

Local action plan to promote access to the health system by indigenous Venezuelans from the Warao ethnic group in Manaus, Brazil: Analysis of the plan´s development, experiences, and impact through a mixed-methods study (2020)

et al. 2021

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Background The provision of care and monitoring of health are essential for indigenous Venezuelans from the Warao ethnic group, who are at risk of decimation. Objective Analyze a Local Action Plan (LAP) to promote access to the health system of indigenous Venezuelans from the Warao ethnic group (IVWEG) in Manaus, Brazil. Method A mixed-methods study was performed. Quantitative data were collected to assess the provision of care and monitoring of health conditions in IVWEG through a survey that was self-completed by healthcare providers. Qualitative narrative data were collected to gain insight into IVWEG that seek care. We applied descriptive statistics, grouping analysis (GA) by hierarchical levels, and multiple correspondence analysis (MCA). Content analysis was applied to qualitative data. Results 106 healthcare providers participated in the study, with the following characteristics: 94 (88.7%) females, 67 (63.2%) pardo race/color, 40 (37.7%) working in primary healthcare, and 49 (46.2%) nurses. In addition, 43 (40.6%) of the healthcare providers reported providing care to IVWEG. Among the providers, 89 (84%) had received training for assisting IVWEG. Additionally, 30 IVWEG were enrolled for interviews in the qualitative phase. The barriers to seeking care were language, distance to health units, and lack of money for transportation. The LAP proved to facilitate access to the health system by indigenous Venezuelans from the Warao ethnic group in Manaus. The study contributed to knowledge on a LAP addressed to IVWEG and helped improved their access to the health system, providing appropriate training for healthcare providers and other relevant actors by implementing a coherent and consistent public health policy at the local level.

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Perspectives on Factors Related to HIV Risk and Preventative Interventions at Multiple Levels: A Study of African Immigrant Women Survivors of Cumulative Trauma

Cited by 13 publications

References 38 publications

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

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

The being safe, health and positively empowered pilot randomized controlled trial: A digital multicomponent intervention for immigrant women with cumulative exposures to violence.

Local action plan to promote access to the health system by indigenous Venezuelans from the Warao ethnic group in Manaus, Brazil: Analysis of the plan´s development, experiences, and impact through a mixed-methods study (2020)

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