Stigma as a Barrier to HIV Prevention among an Indian-Immigrant Population in Canada: A Qualitative Study

Abstract

Purpose: To broaden understanding of the vulnerability to HIV of Indian immigrant communities in Canada. This study focused on the exploration of (a) selected population of Indian immigrants’ perceptions of HIV risk, risk behaviour, and utilization of HIV/AIDS-related services, and (b) the effects of cultural norms of these communities in shaping their capacity for and experiences of responding to HIV in Canada. Methods: A total of 24 semi-structured interviews were conducted with selected population of the Indian-immigrant community. Participants were recruited purposively through a South Asian Punjabi community health service. Each interview lasted from one to two hours and was conducted in English or Punjabi depending on the preference of the participant. Tapes were transcribed verbatim and translated to English. Interview transcripts were coded and analyzed using N-Vivo software. Final themes and sub-themes were decided on by consensus among researchers. Results: Participants discussed cultural taboos and stigma associated with any topic that was perceived to be connected to sexual behaviour. Participants identified that these cultural taboos and the resulting stigma has reduced opportunities for members of the Indian immigrant population to obtain accurate information related to HIV. Although participants agreed that knowledge of HIV was important for prevention, participants discussed a reluctance to talk openly about issues or to seek information publically. Conclusions: Social taboos that limit discourse around sexuality and sexual behaviour negatively impact the effectiveness of HIV prevention education efforts which have targeted mainstream Canadians. This study points to the need for innovative strategies that address social norms and influences among a diverse group of people who maintain close ties with family and friends living in India. Social network theory can provide guidance for carefully planned peer outreach initiatives which may provide an effective means to reach this underserved community.