Developing a Culturally Responsive Sexual and Reproductive Health Curriculum for HIV Prevention among African Immigrant Women

Abstract

Background: Incidence rates of HIV are higher among African-born immigrants than in the general US population. In Minnesota, African-born immigrant women accounted for 40% of all adult females (as assigned by birth) living with HIV and 39% of new diagnosis in 2021, while constituting only 2% of the female population. Findings from a preliminary study point to gender-specific, sociocultural factors as drivers of HIV in this population. Key among these is the lack of sexual and reproductive health knowledge, consequent to cultural norms that regard sex-related discussions as taboo, making African women particularly vulnerable to HIV infection. Conventional HIV prevention programming has not been effective as these approaches lack cultural congruence. In the absence of culturally responsive strategies, AB women are likely to remain at significant risk of HIV. Program Description: This report is a description of the process and key elements employed in developing a curriculum for culturally-responsive, community-based sexual and reproductive health education for HIV prevention among African-born women. The Curriculum Design Team (CDT) of five (5) AB immigrant women adapted and augmented the Becoming A Responsible Teenager (BART) curriculum and developed a culturally congruent theoretical framework to guide programming. Feedback on the curriculum and programming was sought from community members through focus groups with African-born men and women, respectively. Recommendations: Feedback from community-engaged efforts included alignment with cultural norms and values regarding the roles and influence of women; ensuring cultural appropriateness of content and delivery; racial-concordance of facilitators and participants; and use of informal social group setting as critical elements to facilitate engagement of African-born women in the proposed approach to HIV prevention in this population.