Culture, Risk and HIV: The Case of Black African Migrants and Refugees in Christchurch, New Zealand

Black African migrants and refugees are disproportionately affected by heterosexually acquired HIV in New Zealand. Despite this, there are no data on their HIV related sexual attitudes, beliefs and behaviours. This sequential mixed methods study aimed to address this gap. The study had four phases: community consultation, social mapping, a survey, and focus group discussions. Ten community researchers were nominated during consultation and received training in research methods. The community researchers used social mapping techniques to identify social venues and events (such as churches, mosques, soccer games, drums of Africa, Miss Africa Christchurch, baby showers, hair salons, universities, colleges and formal and informal community organisations) from which to recruit participants for the survey phase. The questionnaire from the Mayisha I study in the UK was adapted for use in this study. The survey used a self-administered questionnaire on HIV-related sexual behaviours, attitudes and practices. A sub-sample of survey participants was purposively selected and invited to attend the focus group discussions to explore the issues identified in the survey findings in more depth. In total, 250 participants completed the survey questionnaire and five focus groups were conducted. Participants came from 13 different countries in Africa (Tanzania, Kenya, Ghana, Nigeria, Somalia, Ethiopia, Eritrea, Sudan, South Africa, Zimbabwe, Zambia, Malawi and Botswana). Risk factors identified in this study included low condom use, low HIV risk perception, having more than one sexual partner (including concurrently) and previous sexually transmitted disease (STD) diagnosis. Focus group discussions identified that cultural beliefs and practices played a key role in influencing risk perception, attitudes towards condom use, the practice of multiple concurrent partnerships (MCP), and gender violence. Some of these beliefs were not compatible with the biomedical understandings and approaches that commonly underpin HIV prevention programmes. There is a need therefore to develop HIV prevention programmes that are culturally informed and appropriate to the needs of black Africans in New Zealand