Barriers and enablers to HIV testing among people born in Sub-Saharan Africa and South East Asia

People from Sub-Saharan Africa and South East Asia have the highest rates of HIV diagnosis in Australia in relation to country of birth, and people are often diagnosed late. Victoria Sande and her colleague Corie Gray presented an engaging talk about a collaborative study which aimed to identify barriers and enablers for testing among these high risk groups.

The study involved focus groups across four states (Western Australia, South Australia, Victoria and New South Wales), and included 77 participants. Questions were centered around HIV knowledge, access and barriers to testing, and ways to increase testing.

Generally, results showed a lack of knowledge in relation to testing across the groups.

Identified barriers to testing included:

• ·         Ideas about why people attend health services. Health services were seen by some as only for those who are sick.
• ·         Some indicated they preferred not to know about an illness which was feared.
• ·         The cost of attending health services.
• ·         Fear of homophobia.
• ·         Participants identified gaps in knowledge about where to get tested.
• ·         HIV was not seen by some as an issue in Australia. They felt that they had been tested on arrival and were therefore in a ‘safe’ country. This was reinforced by the perceived invisibility of HIV in Australia. They did not see much information or concern about it in their surroundings.
• ·         Some older participants had negative experiences of HIV in their country of origin and this impacted on their engagement.
• ·         Fear of having to return to their country of origin if receiving a positive diagnosis.
• ·         HIV was seen by some as associated with people different to themselves, people who engaged in activities such as drug use or sex work.

Some of the motivators for testing were:

• ·         GP initiated testing
• ·         Influence of peers

The presenters suggested that alternative testing methods, including self testing and home testing could be attractive to people from these high risk countries.

HIV testing as part of a regular health check was considered a more acceptable approach, as this did not entail identification as someone at higher risk.

Health promotion targeting the broader community might also be more successful, as opposed to targeted campaigns that these groups do not identify with.

The presentation highlighted the importance of a culturally sensitive approach when encouraging testing for people from these high risk backgrounds.