AIDS knowledge among Latinos: the roles of language, culture, and socioeconomic status

AIDS has a disproportionate effect on persons of Latino origin, who have lower knowledge of AIDS than other ethnic groups. This study assessed AIDS knowledge among Latino adults in New Jersey according to acculturation and socioeconomic status. Data on 121 Latino adults were collected in spring 2000 using bilingual telephone interviews. Respondents were selected using the Census' Latino surname methodology. Items were adapted from the National Health Interview Survey Supplement on AIDS Knowledge and Attitudes and the Marin acculturation scale. AIDS knowledge was more strongly associated with language exposure than with self-assessed English or Spanish language abilities. Low educational attainment and bilingual language exposure were associated with lower AIDS knowledge; when other factors were controlled, place of schooling, length of time in the United States, age and gender were not statistically significant. Transmission of HIV via casual contact was widely misunderstood, but general facts about AIDS and likely means of HIV transmission were well known. AIDS education materials should be designed in both English and Spanish and should take into account the lower educational attainment of recent Latino immigrants.     

Knowledge, Attitude and Behavioral Intention to Act Regarding HIV Infection and Prevention in Immigrants from the Former Soviet Union in Germany: A Comparative Study with the Native Population

In Germany, immigrants from Former Soviet Union (FSU) countries represent one of the largest immigrant groups. Some FSU countries face the highest HIV prevalence in the region of Eastern Europe and Central Asia. However, the HIV knowledge, attitude and behavioral intent have not been investigated in FSU immigrants compared to the native population yet. A cross-sectional anonymous survey among 1,205 FSU immigrants and 435 native Germans (aged 18–65 years) in Bavaria. Data analysis from the participating 435 (36 %) immigrants and 334 (76.8 %) natives showed that the immigrants were less knowledgeable (p < .001) about HIV transmission (median score 8 vs. 9, ranged from 0 to 10) and HIV prevention (4 vs. 5, ranged from 0 to 6) than the native Germans, especially with regard to HIV transmission during anal (67 vs. 79.1 %; OR = 1.86 [1.32–2.62]) and oral (49.7 vs. 61.8 %; OR = 1.63 [1.21–2.20]) intercourse and showed a high misconception rate. Age and education were associated with knowledge about sexual HIV transmission; male gender, age and education with HIV prevention by single-use of needles/syringes. In case of a suspected HIV contraction, fewer immigrants would request a test; in case of a confirmed HIV diagnosis fewer would use a condom or inform their sexual partner(s). This first comparative study indicates an urgent need for HIV/AIDS education among FSU immigrants.     

Exploring HIV Knowledge,Risk and Protective Factors Among West African Forced Migrants in New York City

Because of ongoing political and social instability throughout the continent, many Africans have become forced migrants. Unlike immigrants who choose to migrate, forced migrants flee their countries in search of safety and often endure multiple traumatic events during their migration. They are often unprepared for new risks in their adopted country. There is a high incidence of newly-diagnosed HIV cases among West African immigrants in the New York City metropolitan area, but little research to date to understand why this might occur. In order to gain insight, the current pilot study explored HIV knowledge, risk and protective behaviors among 52 West African-born forced migrants in New York City. HIV risk behavior came primarily from unprotected heterosexual activities. While most participants were very knowledgeable about HIV transmission and risk factors, almost half reported that they had not used condoms during sexual activities in the past 6 months. Women were more knowledgeable about HIV transmission, yet reported significantly more STDs than men. Many participants did not know about HIV/AIDS treatments and could not identify HIV/AIDS services and resources within their immigrant communities. Factors influencing HIV risk and protective behaviors among this population are identified and discussed. Suggestions for future research and strategies to reduce risky behaviors while enhancing protective ones among forced West African migrants are highlighted.     

Fear of Deportation May Limit Legal Immigrants’ Access to HIV/AIDS-Related Care: A Survey of Swedish Language School Students in Northern Sweden

The increasing rates of HIV infection that are currently being reported in high-income countries can be partly explained by migration from countries with generalized epidemics. Yet, early diagnosis of HIV/AIDS in immigrants remains a challenge. This study investigated factors that might be limiting immigrants’ access to HIV/AIDS care. Data from 268 legal immigrant students of two Swedish language schools in Northern Sweden were analyzed using logistic regression. Thirty-seven percent reported reluctance to seek medical attention if they had HIV/AIDS. Fear of deportation emerged as the most important determinant of reluctance to seek care after adjusting for socio-demographic factors, knowledge level, stigmatizing attitudes and fear of disclosure. Targeted interventions should consider the heterogeneity of migrant communities and the complex interplay of various factors which may impede access to HIV-related services. The myth about deportation because of HIV/AIDS should be countered.     

Innate Health Threat Among a Visibly Hidden Immigrant Group: A Formative Field Data Analysis for HIV/AIDS Prevention Among Zimbabwean Workers in Botswana

As a result of the collapse of the national economy and political instability, Zimbabwe has experienced a diaspora in recent years. Although Zimbabweans are now the largest immigrant group in most sub-Saharan countries, Zimbabwean immigrants are a mostly illegal and socioeconomically marginalized population. This study explores the lives of Zimbabwean workers in Botswana from a health communication perspective and provides suggestions for accelerating the diffusion of HIV/AIDS prevention information and practices among the target population. In particular, this ethnographic report portrays how the Zimbabwean workers in Botswana make sense of their surroundings and perceive information on HIV/AIDS prevention and other public health risks. Field data analysis highlights several communication features among the immigrants, including reliance on interpersonal communication, high rate of mobile phone adoption, inaccurate public awareness on HIV/AIDS and prevention messages, and stagnated communication with health care services. By connecting Dervin's sensemaking theory to Roger's diffusion of innovations theory, the suggestions from this study can be applied to design HIV/AIDS prevention interventions for the immigrants and socioeconomically marginalized groups.     

Immigration and HIV/AIDS in the New York Metropolitan Area

Because the HIV pandemic undergoes continual change in its locations and affected populations, it is crucial to study HIV risk behaviors among mobile and immigrant groups within and across borders. The impact of cross-cultural migrations and the importance of studying that impact in terms of demographic characteristics as well as cultural and environmental factors has not received adequate attention in public health research. This collaborative analysis utilizes data from three studies of immigrant groups in New York to describe and compare these factors that provide the context for risk and prevention of HIVAIDS and other health challenges. Data discussed were obtained utilizing multi-method approaches to identify and describe HIV risks among both new and more established immigrant populations within the urban settings of North America, with NYC as a central focus. Demographic and epidemiological data situate the analysis within the larger contexts of US migration and the HIV/AIDS epidemic in NYC. The authors identify risk and protective factors embedded to varying degrees in immigrants' multiple cultures and sub-cultures. The three populations studied include: 1) new Hispanic immigrants from the Dominican Republic, Mexico and Central America; 2) West Indian (Caribbean) immigrants from Jamaica, Trinidad/Tobago and other anglophone Caribbean nations; and 3) South Asian immigrants from India (Indian Americans). The paper seeks differences and commonalities, focusing on the social, attitudinal and behavioral factors that contribute to increased HIV/AIDS vulnerability among these populations. The data presented also identify some of the attitudes and behaviors of individuals and groups, as well as other facilitators and obstacles to transmission for immigrants as they adapt to new environments. Topics addressed include factors affecting HIV/AIDS vulnerability of immigrant groups, goals and expectations, health and mental heath issues, gender role change, sexual risk, alcohol and other drug use, perception of HIV/AIDS risk and implications for prevention.     

AIDS knowledge and sexual activity among Flemish secondary school students: a multilevel analysis of the effects of type of education

Background  

The behavior of adolescents puts them at an increased risk for HIV and other STIs, and their knowledge about HIV/AIDS is often inadequate. An understanding of how AIDS knowledge and sexual activity co-vary among Flemish secondary school students and of how education type, specifically, affects these students is limited. This study addresses the question of whether the effects of education type on HIV/AIDS knowledge and sexual activity are independent of the socio-demographic characteristics of the students.     

Knowledge of HIV Risk Factors Among Immigrants in Thailand

This study is based on a sample of 3,374 immigrants from Cambodia and Myanmar who worked in 17 different provinces in Thailand. Many immigrants workers had not even heard of HIV/AIDS before coming to Thailand, but most have received instruction about HIV/AIDS from some source in Thailand, and a large majority are now aware of HIV/AIDS. While immigrant workers in Thailand are fairly knowledgeable about the risk factors for HIV transmission, important gaps remain. Women, persons with less than five years of education, seafarers, agricultural workers, those who do not personally know anyone affected by HIV/AIDS, and those who have not yet received instruction in HIV/AIDS are the ones most likely to have gaps in their knowledge of HIV/AIDS risk factors.

Adherence to antiretroviral therapy: a qualitative study with physicians from Rio de Janeiro, Brazil

Brazil provides free antiretroviral (ARV) therapy to some 150,000 individuals living with HIV/ AIDS). ARV regimens require optimal adherence to achieve undetectable viral loads and to avoid viral resistance. Physicians play a key role to foster ARV adherence, but until now little is known about the communication between physicians/ people living with HIV/AIDS in this setting. In-depth interviews were conducted with 40 physicians treating people living with HIV/AIDS at six public reference centers in Rio de Janeiro, Brazil. Interview topics included: experiences in the treatment of people living with HIV/AIDS, relationship and dialogue with patients, barriers/facilitators to adherence, and effectiveness of available services. Barriers to ARV adherence were mainly related to the low quality of patient-provider relationship. Other barriers were related to "chaotic" patients' lifestyles, and inadequate knowledge and/or negative beliefs about HIV/AIDS and ARV effectiveness. It is necessary to improve networking between services, establish agile referral systems, and improve health professionals' integration. These structural changes could contribute to improved adherence, resulting in improved quality of life for people living with HIV/AIDS.     

Knowledge,attitudes and practices of Greek health professionals,in relation to AIDS

In order to improve educational programmes directed at health care workers we investigated their knowledge, attitudes and practices in relation to HIV/AIDS.An anonymous self-administered questionnaires was distributed to 609 health care workers. Of these, 59.6% agreed to participate (42.4% of the medical doctors, 74.3% of the nurses and 79.6% of the laboratory technicians, health visitors and other health care workers).All studied groups believed that their knowledge of HIV modes of transmission (84.3%) was sufficient. In contrast, a relatively small percentage reported knowledge of the clinical spectrum of HIV infection (48.8%) and the diagnostic assays (57.6%). Nearly all the study participants believe (92.8%) that there is a risk of acquiring HIV infection during the hospitalization of HIV/AIDS patients. Obligatory screening of all patients was reported by nearly all participants (90.6%) as a chance to minimize their occupational risk.Although health care workers reported satisfactory knowledge of safety measures (87.0%), only 56.7% used gloves and 38.8% accept the hospitalization of HIV/AIDS patients.In spite of the educational programmes for AIDS in Greece, this study demonstrates that health professionals' knowledge and precautionary measures are not sufficient. As a result, a small percentage of them treat AIDS patients without discrimination. There is an urgent need to implement specific educational programmes for health professionals so that they will safely provide high quality care to people affected by HIV/AIDS.Corresponding author.     

HIV/AIDS knowledge and condom use among Somali and Sudanese immigrants in Denmark

AIMS: This study explores the knowledge, attitudes and practices among Somali and Sudanese immigrants in Denmark with regard to HIV/AIDS and condom use. MATERIAL AND METHODS: A 78-item questionnaire, divided into five thematic sections, was given to 192 purposively selected Sudanese and Somalis of both sexes, aged 18-49, who had lived in Denmark for one or more years. It was administered in Arabic and Somali in four locations and supplemented by 13 semi-structured interviews. RESULTS: Education, sex, and nationality, but not length of residence in Denmark, were positively associated with knowledge about HIV/AIDS. Less than half of both men and women scored more than 70% on the knowledge portion of the questionnaire, while Sudanese knew more than Somalis. Men had a more negative attitude towards condoms than women, but greater knowledge about them. One-third of the women reported never having seen or heard of a condom, and almost half had never received information about condoms. Both sexes preferred receiving such information from the TV or friends instead of family doctors or HIV-positive individuals. CONCLUSIONS: This study suggests that knowledge about HIV/AIDS is low in these two Danish immigrant groups, both of which are characterized by reported incidence rates that are higher than the national average. The groups receive little information, while condom knowledge is particularly low among poorly educated women, and men have a negative attitude to condom use. The findings indicate a need for targeted, culturally sensitive HIV/AIDS information and advice.     

Sociocultural and Structural Barriers to Care Among Undocumented Latino Immigrants with HIV Infection

Timely entry into HIV care is critical for early initiation of therapy, immunologic recovery and improved survival. However, undocumented Latinos are more likely to enter HIV care late in the disease course and with concurrent AIDS. We conducted a qualitative study to examine the circumstantial, situational and social factors that uniquely affect entry and retention in care for this population. Between June and August 2006, we conducted semi-structured, in-depth, individual interviews with 22 undocumented Latino immigrants living with HIV infection. The interviews were audiotaped, transcribed and reviewed for accuracy. Data was analyzed using a grounded theory approach. Word content was coded and sorted by themes using AnSWR software. Emergent themes related to health care barriers include (1) the challenges of dealing with HIV stigma and rejection from family and community; and (2) the experienced and perceived structural barriers of accessing care as an undocumented individual. Societal intolerance of HIV and stigma-related experiences result in feelings of secrecy and shame. In addition, the undocumented state complicates the situation even further. These unique barriers include fear of deportation, work restrictions, inadequate translation services and difficulties meeting paperwork requirements. This study offers insight into the unique sociocultural and structural barriers faced by undocumented Latinos with HIV infection. Understanding and addressing these barriers will prove vital in the development and implementation of strategies to promote early entry into HIV care.     

某职业技术学院学生艾滋病相关知识、态度及性观念调查

目的了解职业技术学院学生对艾滋病的知识、态度和性观念的现状,为探索有针对性的艾滋病行为干预提供依据。方法采用分层整群抽样的方法对一所职业技术学院的502名学生进行匿名式问卷调查。结果学生对艾滋病三大传播途径有较高的知晓率,但是还缺乏系统的知识结构,大部分学生对艾滋病感染者和与之相处的态度还存在着偏差和歧视。结论对职业技术学生开展综合性的艾滋病防治和性教育非常必要,有助于提高他们自身的防病知识,并促进其行为改变。     

徐汇区建筑工人性病艾滋病及安全套使用知信行状况分析

[目的]了解建筑工地工人性病艾滋病（STDs／AIDS）及安全套的知识、态度及行为,为开展健康教育提供指导依据。[方法]采取整群随机抽样的方法,对上海市徐汇区6个建筑工地的620名建筑工人进行问卷调查,主要包括性病艾滋病的知识、态度和安全套的认识及使用等内容。[结果]在性病艾滋病知识、态度及行为方面,有关“性病是可预防的”、“与艾滋病病人不用安全套的性行为可以传播艾滋病毒”、“感染艾滋病病毒的孕妇可以将病毒传染给胎儿”及“艾滋病病毒携带者可能会看起来很健康”等问题的回答正确率较高,在79．9％～96．76％之间。但对于几个关于感染途径的问题（如与艾滋病人握手,共用毛巾、马桶,接吻,咳嗽及昆虫叮咬等）,大多数人存在错误认识,回答正确率仅为4．60％～35．9％。在安全套的认识和使用方面,有关安全套的正确使用方法,仅有11．11％的人知道用食用油或凡士林作为安全套润滑剂会导致安全套破裂,27．21％的人知道戴安全套时应该把顶部小囊中的空气挤掉,29．47％的人知道在把安全套戴上阴茎之前,安全套不应该被完全展开。发生商业性性行为时,61．10％的人会选择使用安全套,但与配偶或情人发生性关系时,仅有不到25％的人使用安全套。[结论]建筑工人多数来自农村,文化程度较低,大多居住在建筑工地,与外界相对隔绝,对性病艾滋病知识比较缺乏,安全套的认识及使用率较低,应采取有针对性的宣教方式,加强对建筑工人相关防治知识的宣传及安全套的推广使用,使性病艾滋病防治知识得以提高。     

The smokescreen of culture: AIDS and the indigenous in Papua, Indonesia

In health transition studies on AIDS, government activities typically have been accorded less importance than local cultural practices. Certain social and cultural values, theorists argue, prevent potentially at-risk individuals from taking effective precautions to prevent HIV infection during sexual intercourse. This paper shows how a focus on culture is inadequate to understanding the issue of risk when the AIDS epidemic occurs in a colonial context. A study conducted in 2001 in Papua (West Papua), eastern Indonesia, shows that ongoing colonial relationships between indigenous Papuans and in-migrant Indonesians create inequities in AIDS awareness. Rates of HIV infection in Papua are high, but indigenous Papuans have a low level of awareness. Drawing on a survey of condom use and the sex work industry, this paper shows that government values, and economic conditions, need to be scrutinized as closely as culture in order to provide effective AIDS prevention in Papua.     

HIV/AIDS knowledge, attitudes and behaviors assessment of Chinese students: a questionnaire study

The objective of this study was to assess students' knowledge, attitudes and practices on HIV and AIDS. A questionnaire was administered to a cross section of 259 Chinese undergraduates. Respondents were asked to provide information about knowledge and attitudes about HIV/AIDS. Study results indicated that the majority of undergraduates had a moderate level of HIV and AIDS knowledge, acceptance and attitudes towards people with HIV and AIDS. Boys had more acceptance and positive attitudes towards people with HIV and AIDS than girls. Students majoring in medicine performed better (more knowledgeable and accepting) than non-medical students. Differences between students with various monthly expenditures were found-- 6.2% of students had 3-5 sexual partners which has rarely been found in Chinese students; most students did not know HIV VCT centers and most students did not show their confidence for controlling of HIV and AIDS in China. In conclusion, students' knowledge about HIV/AIDS was uneven. A peer educational program to talk about self esteem, healthy sexual attitudes, being human-accepting and loving should be developed in the near future.