PLoS ONE
Volume 13, Issue 4, 2018

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 (Article) (Open Access)

Kuehne A. , Koschollek C. , Santos-Hövener C. , Thorlie A. , Müllerschön J. , Tshibadi C.M. , Mayamba P. , Batemona-Abeke H. , Amoah S. , Greiner V.W. , Bursi T.D. , Bremer V.*
  • a Robert Koch Institute, Department for Infectious Disease Epidemiology, Unit for HIV/AIDS, STI and Blood-borne Infections, Berlin, Germany
  • b Robert Koch Institute, Department for Infectious Disease Epidemiology, Unit for HIV/AIDS, STI and Blood-borne Infections, Berlin, Germany, Charité University Medicine, Berlin, Germany
  • c Robert Koch Institute, Department for Infectious Disease Epidemiology, Unit for HIV/AIDS, STI and Blood-borne Infections, Berlin, Germany
  • d Robert Koch Institute, Department for Infectious Disease Epidemiology, Unit for HIV/AIDS, STI and Blood-borne Infections, Berlin, Germany
  • e Robert Koch Institute, Department for Infectious Disease Epidemiology, Unit for HIV/AIDS, STI and Blood-borne Infections, Berlin, Germany
  • f Münchner AIDS-Hilfe e. V., Munich, Germany
  • g Aidshilfe Essen e.V., Essen, Germany
  • h Pamoja Afrika e.V., Cologne, Germany
  • i Afrikaherz Berlin, Verband für interkulturelle Arbeit, Regionalverband Berlin/Brandenburg e.V., Berlin, Germany
  • j Maisha e.V., Frankfurt am Main, Germany
  • k Hannöversche AIDS-Hilfe e.V., Hanover, Germany
  • l Robert Koch Institute, Department for Infectious Disease Epidemiology, Unit for HIV/AIDS, STI and Blood-borne Infections, Berlin, Germany

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. © 2018 Kuehne et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Author Keywords

[No Keywords available]

Index Keywords

Germany educational status HIV Infections Africa south of the Sahara sexual behavior Human immunodeficiency virus infection multicenter study clinical trial Cross-Sectional Studies community care health insurance human epidemiology Health Behavior language ability middle aged medical research controlled study Aged screening test ethnology medical practice religion prognosis Human immunodeficiency virus prevalence Patient Education as Topic sexually transmitted disease knowledge condom use patient counseling Surveys and Questionnaires asylum seeker Humans quality of life Young Adult income Adolescent migrant male Emigrants and Immigrants cross-sectional study female psychology pilot study risk factor questionnaire Social Stigma Health Knowledge, Attitudes, Practice patient education high risk behavior Risk-Taking disease transmission feasibility study infection prevention major clinical study adult Article migration sample size virus hepatitis participatory research Community-Based Participatory Research Transients and Migrants quantitative analysis acquired immune deficiency syndrome attitude to health
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85045210071&doi=10.1371%2fjournal.pone.0194244&partnerID=40&md5=80c4984164c492afdb5d9adef0102ef4
DOI: 10.1371/journal.pone.0194244
ISSN: 19326203
Original Language: English