HIV & AIDS Project
HIV/AIDS prevention project among African Immigrants in Norway: Preventive Practices Based on Behavioral change, condom use and safe sex.
Human immunodeficiency Virus (HIV) infection remains to be a major public health concern in Europe. Surveillance data published by the European Centre for Disease Prevention and Control and the World Health Organization Regional Office for Europe indicate that, in 2009, 53 427 cases of HIV were diagnosed and reported by 49 of the 53 countries in the WHO European Region( (1). Migration has been acknowledged as a factor influencing the epidemiology of HIV in Europe (1). In 2005, 46% of all cases of heterosexually acquired HIV infection in Western Europe involved migrants from high prevalence countries (2). Norway is one of the western European countries with increasing cases of new HIV infection. A 2010 report shows a continued increase in the number of newly infected cases among immigrants in Norway (3). The HIV epidemic in Norway has been mainly driven by men who have sex with men (MSM), but recently sexually transmitted cases are on the rise (4). The 75% of HIV cases with immigrant background in Norway in 2010, 75% were from Africa, mostly East Africa. Thus, immigrants from East Africa are one of the most vulnerable groups in acquiring HIV. Effective behavior change programs targeting this immigrant group are important to prevent new HIV cases and as well as to minimize stigma and discriminations subjected to HIV patients within African immigrants.
Migration places populations in situations of greater risk for poor health in general and HIV in particular (5)). The linkages between migration and HIV/Aids are largely related to the conditions and structures of the migration process itself, as in the countries of origin, transit and destination (5). In host countries specifically, factors like poverty, exploitation, lack of legal protection, social exclusion and discrimination may increase the risk of exposure to HIV and may reduce the individual’s ability to protect him- or herself from infection (6). Other potential risk factors for migrants include separation from families and partners, besides separation from the socio-cultural norms that guide behaviors in more stable communities. Barriers to health services, including legal, socioeconomic, linguistic and cultural constraints, may result in a reduced utilization of services, in particular for HIV/Aids prevention and care, which makes these groups more vulnerable to HIV and their related complications (7).
Timely HIV testing may lead to improved clinical outcomes through early diagnosis and access to treatment as antiretroviral therapy makes individuals less infectious. African immigrant groups were reported to have low knowledge on HIV infection and had negative attitude towards the use of condoms (8). Delivery of effective behavior change strategies is central to reversing the national HIV epidemic. Awareness and community education programs that focus on safe sexual behavior and condom use may prevent acquiring as well as the transmission of HIV infection as it enhances individual behavioral change toward reduced risky sexual behavior (9). Moreover, effective behavior change programs may prevent new cases to come to Norway, as African immigrants in Norway often travel to their home countries and may acquire the infection. “Effective HIV prevention addresses the specific needs and circumstances of the target population and aims to affect multiple determinants of human behavior, including individual knowledge and motivations, interpersonal relationships, and societal norms” (10). African Health Organization aims to increase knowledge on HIV infection and simultaneously change risky sexual behaviors among African immigrants in Norway
(1) ECDC. Migrant Health Series: Epidemiology of HIV and AIDS in Migrant Communitiesand Ethnic Minorities in EU/ EEA countries, ECDC, ISBN 978-92-9193-204-7,Stockholm, Sweden. 2010.
(2) ECDC. Migrant Health Series: Background Note to the ‘ECDC Report on Migrationand Infectious Diseases in the EU. 2009.
(3) Norwegian Institute of Public Health. HIV situation in Norway as of 31st December 2010. 2011.
(4) Aavitsland P, Nilsen O. [HIV-infection in Norway before 2006]. Tidsskr Nor Laegeforen 2006 Nov 30;126(23):3125-30.
(5) IOM. HIV/AIDS and Populations Mobility: Overview of the IOM Global HIV/AIDS Programme 2006. 2006.
(6) Soskolne V, Shtarkshall RA. Migration and HIV Prevention Programmes:Linking Structural Factors, Culture, and Individual Behaviour-An IsraeliExperience. Social Science & Medicine 2002;55(8):1297-307.
(7) Salama P, Dondero TJ. HIV Surveillance in Complex Emergencies. AIDS 2001;15(3):4-12.
(8) Lazarus JV, Himedan HM, Ostergaard LR, Liljestrand J. HIV/AIDS knowledge and condom use among Somali and Sudanese immigrants in Denmark. Scand J Public Health 2006;34(1):92-9.
(9) Ehrlich S, Organista K, Oman D. Migrant Latino Day Laborers and Intentions to Test for HIV. AIDS and Behavior 2007;11(5):743-52.
(10) Global HIV Prevention. Behavior Change and HIVPrevention: (Re)Considerations for the 21st Century. 2010.