TOGETHER Project to Increase Understanding of the HIV Epidemic among Sub-Saharan African Migrants: Protocol of Community-Based Participatory Mixed-Method Studies
BACKGROUND:
Sub-Saharan
African Migrants (SAM) are the second largest group affected by HIV/AIDS in
Belgium and the rest of Western Europe. Increasing evidence shows that, more
than previously thought, SAM are acquiring HIV in their host countries. This
calls for a renewed focus on primary prevention. Yet, knowledge on the
magnitude of the HIV epidemic among SAM (HIV prevalence estimates and
proportions of undiagnosed HIV infections) and underlying drivers are scarce
and limit the development of such interventions.
OBJECTIVE:
By
applying a community-based participatory and mixed-methods approach, the TOGETHER
project aims to deepen our understanding of HIV transmission dynamics, as well
as inform future primary prevention interventions for this target group.
METHODS:
The
TOGETHER project consists of a cross-sectional study to assess HIV prevalence
and risk factors among SAM visiting community settings in Antwerp city,
Belgium, and links an anonymous electronic self-reported questionnaire to oral
fluid samples. Three formative studies informed this method: (1) a social
mapping of community settings using an adaptation of the PLACE method; (2) a
multiple case study aiming to identify factors that increase risk and
vulnerability for HIV infection by triangulating data from life history
interviews, lifelines, and patient files; and (3) an acceptability and feasibility
study of oral fluid sampling in community settings using participant
observations.
RESULTS:
Results
have been obtained from 4 interlinked studies and will be described in future
research.
CONCLUSIONS:
Combining
empirically tested and innovative epidemiological and social science methods,
this project provides the first HIV prevalence estimates for a representative
sample of SAM residing in a West European city. By triangulating qualitative
and quantitative insights, the project will generate an in-depth understanding
of the factors that increase risk and vulnerability for HIV infection among
SAM. Based on this knowledge, the project will identify priority subgroups
within SAM communities and places for HIV prevention. Adopting a
community-based participatory approach throughout the full research process
should increase community ownership, investment, and mobilization for HIV
prevention.
Below: Outline of the TOGETHER project
By: Loos J1, Vuylsteke B, Manirankunda L, Deblonde J, Kint I, Namanya F, Fransen K, Colebunders R, Laga M, Adobea D, Nöstlinger C.
- 1HIV and Sexual Health Unit, Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium. jloos@itg.be.
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