Abstract
BackgroundMigrants from sub-Saharan Africa (MisSA) are a relevant sub-group for HIV-transmission in Germany. A total of 10-15 % of all newly diagnosed cases are MisSA, and approximately one third acquired HIV in Germany. There is limited information on knowledge, attitudes, behaviors and practices (KABP) regarding sexual health in African communities residing in Germany.MethodsFrom October-December 2013 we conducted a cross-sectional survey on KABP regarding HIV, viral hepatitis (HEP), and sexually transmitted infections (STI) among MisSA in Hamburg as a community-based participatory research project to identify knowledge gaps, sexual risk behavior regarding HIV/HEP/STI, HIV/STI-testing history and attitudes toward people living with HIV (PLWH). Trained peer researchers recruited participants through outreach. Questionnaires in German, English or French were either administered face-to-face or self-completed. Questions on knowledge about HIV/HEP/STI presented true statements; participants were asked if they knew the information before. To detect differences in sub-groups, unadjusted odds ratios (OR) were calculated, and a multivariate analysis for knowledge on HIV/HEP/STI was performed.ResultsThe final sample included 569 participants of whom 57 % were men. Most participants originated from Western and Central sub-Saharan Africa. Median time living in Germany was 6 years. Overall, 28 % had a university degree and 54 % reported a good level of German language. Over 80 % knew the risks for HIV transmission. A total of 44 % of respondents wrongly assumed that an HIV-diagnosis might lead to deportation and 64 % were not aware of the free and anonymous local HIV/STI-testing service. The proportion of participants with knowledge of presented facts on HEP varied from 40-58 %. The respective proportion on STI was 28-68 % and better among women compared to men (44 % vs. 54 %; OR = 1.45; 95 % CI 1.22-1.74). Men reported more often casual sex partners than women (43 % vs. 23 %; OR = 2.6; 95 % CI 1.7-4.0), and more frequently a previous STI (58 % vs. 39 %; OR = 2.1; 95 % CI 1.1-4.1). Overall, 16 % of women reported a history of sexual violence. The majority of respondents (75 %) reported that they would treat PLWH like any other person.ConclusionStudy participants demonstrated good knowledge on HIV-transmission but knowledge gaps regarding HIV/STI-testing services, HEP and STI. This calls for targeted interventions providing more information about these topics in African communities in Hamburg and possibly also elsewhere.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2098-2) contains supplementary material, which is available to authorized users.
Highlights
Migrants from sub-Saharan Africa (MisSA) are a relevant sub-group for HIV-transmission in Germany
HIV, Hepatitis B and C in German-based migrants from sub-Saharan Africa Epidemiological studies from different Western European countries show that migration has an impact on the epidemiology of HIV and viral hepatitis [1]
The majority of participants came from countries in Western (75 %) and Central (16 %) sub-Saharan Africa
Summary
Migrants from sub-Saharan Africa (MisSA) are a relevant sub-group for HIV-transmission in Germany. In 2011, eighteen countries provided data to the European Center for Disease Control and Prevention (ECDC) on whether a reported hepatitis B case was imported (not acquired in reporting country), which was true for 53 % of all reported cases [3]. This shows that migrant populations are disproportionately affected by HIV and viral hepatitis and underlines the importance of surveillance for these infections. Among all newly diagnosed HET cases, 70 % are people with countries of origin other than Germany; and between 40-50 % of HET annually are migrants from sub-Saharan Africa (MisSA) [2, 6]. Since 2013 there has been an increase in diagnosed HIV cases in female MisSA [4]
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