Risk Perception and Beliefs Regarding HIV Infection among Ethiopian Immigrants

Abstract

In Ethiopia, approximately 7.5% of the urban population is HIV-positive, and countrywide 1.5 million people are living with HIV. Between 1990 and 2000, immigration into the United States by African-born immigrants increased by 130%. Of this immigrant population, individuals from Ethiopia make up a significant portion. Although there is a rich literature addressing the beliefs regarding HIV and risk perception among some immigrant populations in the United States, few studies target Ethiopian-born residents. Thus, a survey-based study addressing demographics, acculturation, awareness, beliefs and risk perception, attitudes toward susceptibility for infection, and risk behaviors targeted Ethiopian-born residents of San Diego, California. Results indicate a separation between understanding of HIV transmission and personal risk perception for infection in a young, highly educated, predominantly male participant pool. As an initial study of HIV beliefs and risk perception in the immigrant Ethiopian population, our results provide information on specific areas warranting further investigation.

HIV/AIDS Among African-Born Residents in the United States

“…Six studies have explored the social context of HIV in African communities in the US [18, 22, 25, 27, 28, 30]. These studies are primarily qualitative and uncover themes that include high levels of stigma within African communities against persons living with HIV, structural barriers to screening and care, discordant beliefs and behaviors associated with misperceptions of risk and treatment, fears of deportation, and gender inequality in accessing health care resources.…”

“…These studies also describe how lack of knowledge of treatment is closely linked with fatalistic attitudes towards testing and seeking care [28]. Two of the studies stand out in that they surveyed well-educated immigrant groups and found a high level of knowledge of HIV/AIDS, accompanied by paradoxically elevated rates of high-risk behaviors such as unprotected sex or sexual concurrency [18, 30]. …”

“…Meeting the distinct needs of Africans in the US with respect to HIV is further complicated by structural barriers to care, including undocumented status, language, and a low level of acculturation [18, 22, 25, 27, 28, 30]. Social barriers, such as stigma against people living with HIV within highly cohesive communities, fatalistic attitudes towards testing and treatment, unequal access to health services between genders, and high levels of diversity between the many different African communities, all highlight the difficulty of increasing access to diagnosis and care [18, 22, 25, 27, 28, 30]. But while the growing population, the lack of accurate estimates of incidence, and the distinct set of social and structural barriers all illustrate the complexity of improving HIV screening and care services for this population, they also highlight the importance of further research and public health programming to address it.…”

HIV risk and barriers to care for African-born immigrant women: a sociocultural outlook

“…Qualitative studies have explored the social context of HIV and related needs in African immigrant communities in the US 16–20. Key emerging themes from these studies include 1) high levels of stigma,16–19 2) structural and health care system-related barriers to screening and care,16,18,19 3) beliefs that foster misperception of risk and treatment and associated sexual and health-seeking behaviors,17,19 and 4) fear of deportation due to undocumented status 16.…”

“…Qualitative studies have explored the social context of HIV and related needs in African immigrant communities in the US. 16 – 20 Key emerging themes from these studies include 1) high levels of stigma, 16 – 19 2) structural and health care system-related barriers to screening and care, 16 , 18 , 19 3) beliefs that foster misperception of risk and treatment and associated sexual and health-seeking behaviors, 17 , 19 and 4) fear of deportation due to undocumented status. 16 Additional literature supports the higher vulnerability of AB women to HIV due to economic dependence, 16 lower literacy levels associated with limited access to relevant resources, 17 and stronger stigma associated with women acquiring HIV compared with men.…”