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Harambee! 2.0: The Impact of HIV-Related and Intersectional Stigmas on HIV Testing Behaviors Among African Immigrant Communities in Seattle,Washington
Authors:Daniel  Nahom A.  Hassan  Shukri A.  Mohamed  Farah  Sheikh  Najma  Basualdo  Guiomar  Schwartz  Rahel  Gebreselassie  Beyene Tewelde  Beyene   Yikealo K.  Gabreselassie  Luwam  Bayru  Kifleyesus  Tadesse  Bethel  Libneh  Hirut Amsalu  Shidane   Mohamed  Benalfew   Sophia  Ali   Ahmed  Rao   Deepa  Kerani   Roxanne P.  Patel  Rena C.
Affiliation:1.Department of Biology, UW, Seattle, WA, USA
;2.Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA
;3.Somali Health Board, Tukwila, WA, USA
;4.Department of Global Health, UW, Seattle, WA, USA
;5.Department of Anthropology, UW, Seattle, WA, USA
;6.Ethiopian Community in Seattle, Seattle, WA, USA
;7.Ethiopian Health Board, Seattle, WA, USA
;8.Eritrean Health Board, Seattle, WA, USA
;
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.

Keywords:
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