In the second phase of our work, we wanted to further explore exactly how HIV-related and intersectional stigmas impact HIV testing behaviors, so we conducted formative work using qualitative study methods. We conducted key informant interviews (KIIs) and focus group discussions (FGDs) with diverse community leaders, including religious leaders, health professionals, persons living with HIV, and lay community members. In order to minimize the risk of inadvertent disclosure or trauma, we did not explicitly recruit persons living with HIV for focus group discussions.
We conducted 30 KIIs and 5 FGDs and found 3 dominant themes:
- HIV-related and intersectional stigmas’ impact on HIV testing behaviors
- Community resources and resilience factors
- Cultural beliefs/attitudes around preventative care
Overall we found that the intersecting identities of race/ethnicity, immigrant status, and non-English language preference create additional layers of stigma and barriers to HIV testing. Additionally, more fundamental cultural and religious beliefs and attitudes towards preventative care and complex western healthcare systems create barriers to preventative care and overall health-seeking behavior. Finally, in these communities social cohesion is strong, religious leaders are key gatekeepers, and a wealth of community resources and culturally-rich media already exist, which can all be leveraged to help improve HIV testing.
More detailed results and analysis can be found in our second and third publications: “Harambee! 2.0: The Impact of HIV-Related and Intersectional Stigmas on HIV Testing Behaviors Among African Immigrant Communities in Seattle, Washington” & “‘They Wait until the Disease Has Taking over You and the Doctors Cannot Do Anything about It’: Qualitative Insights from Harambee! 2.0 “. With 2 more papers set to be published from this phase of the project.