HIV-Related Knowledge and Practices among Asian and African Migrants Living in Australia: Results from a Cross-Sectional Survey and Qualitative Study
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Demographics
3.2. Knowledge, Attitudes and Practices Regarding HIV Prevention
3.2.1. Pre-Exposure Prophylaxis
3.2.2. Undetectable = Untransmittable (U = U)
3.2.3. Sexual Behaviors and Condom Use
3.3. Knowledge, Attitudes and Practices Regarding HIV Testing
3.3.1. Timing of Last Test for STIs or BBVs
The first thing, I suppose we, the refugees, when we first came, we thought this place is safe, because some of these STDs are not existing here, because of the good health services that people are giving to people.(SSA man, Western Australia, focus group)
When we had the [pre-migration] interview, we got tested for HIV, syphilis, hepatitis A, B, and C, and gonorrhea. All of this, and chest x-ray to make sure you haven’t got TB and all that. So I even said to my husband, “Maybe where we’re going, nobody dies.”.(SSA woman, Western Australia, focus group)
I never really seriously thought about [blood-borne viruses], any risk in Australia … I think because it seems really controlled well … if the Australian government test every single migrant that means—like, I wouldn’t say no infections, but more, how do I say? Less chance.(NEA man, Queensland, interview)
I think at the beginning our family and many of our parents’ friends, … they don’t go to doctors and hospital unless they’ve broken their arms or something like serious. I don’t think they used to go to doctors as much as they do now when they first arrived.(NEA man, Queensland, interview)
If they don’t feel anything wrong, they don’t go to the GP … They only go when they feel they’re sick.(SEA woman, Queensland, interview)
[In my birth country] you don’t really go to the doctor and get checked out unless it’s serious … Here … you don’t feel the need to go to a doctor unless they start to feel sick.(SEA woman #1, Western Australia, interview)
Only when we [are] sick, just go to see a doctor, and that’s it. We don’t do that kind of thing [preventative health services such as vaccinations] so I’m not really familiar when I came here.(SEA woman, Western Australia, interview)
[People from my country are] … afraid of being judged. It’s all about your thoughts and you’re afraid people will judge you, but it might not be the case. It’s just you get in your own head and you would be afraid of being judged. They would search it up of course, they would Google because it’s anonymous. But to actually come up to a person … or to a doctor and ask them, “How do I get - I want to get myself checked, how do I do it?” I don’t think they would ever do it.(SEA woman, Western Australia, interview)
3.3.2. Type of Last STI/BBV Test
I didn’t even know I was getting checked until I got the results … I was like okay, just go from one room to another and get myself checked, it’s like do whatever you want. I didn’t even know until the results came and I got the results, I’m like “Huh, I got an STD check”.(SEA woman, Western Australia, interview)
3.3.3. Reason for Last HIV Test and Attitudes to Testing
3.3.4. Characteristics of Respondents Who Reported HIV Testing
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Place of Birth | Age (Years) | Gender | Length of Time in Australia (Years) | SEIFA Decile | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
18–29 | 30–39 | 40–49 | 50–59 | 60+ | N/A | Man | Woman | N/A and Other | ≤9 | 10–19 | 20–29 | 30+ | N/A | 1–2 | 3–4 | 5–6 | 7–8 | 9–10 | N/A | |
SSA (n = 363) | ||||||||||||||||||||
Eastern 1 (n = 270) | 86 | 91 | 60 | 25 | 8 | 0 | 124 | 137 | 9 | 85 | 161 | 9 | 3 | 12 | 55 | 29 | 70 | 47 | 14 | 55 |
Western 2 (n = 53) | 18 | 11 | 9 | 10 | 3 | 2 | 24 | 38 | 1 | 21 | 21 | 4 | 1 | 6 | 21 | 4 | 12 | 3 | 2 | 11 |
Central 3 (n = 24) | 10 | 7 | 5 | 1 | 0 | 1 | 15 | 9 | 0 | 11 | 13 | 0 | 0 | 0 | 8 | 4 | 3 | 1 | 0 | 8 |
Southern 4 (n = 16) | 1 | 7 | 7 | 1 | 0 | 0 | 4 | 11 | 1 | 6 | 6 | 1 | 2 | 1 | 2 | 1 | 5 | 2 | 5 | 1 |
SEA (n = 547) | ||||||||||||||||||||
Cambodia (n = 27) | 12 | 6 | 7 | 1 | 1 | 0 | 16 | 10 | 1 | 18 | 6 | 0 | 3 | 0 | 7 | 5 | 3 | 2 | 4 | 6 |
Indonesia (n = 165) | 31 | 37 | 46 | 34 | 15 | 2 | 50 | 115 | 0 | 70 | 50 | 21 | 18 | 6 | 15 | 24 | 33 | 40 | 37 | 16 |
Malaysia (n = 66) | 21 | 14 | 9 | 7 | 15 | 0 | 24 | 40 | 2 | 26 | 19 | 4 | 14 | 3 | 3 | 10 | 14 | 16 | 17 | 6 |
Myanmar (n = 27) | 8 | 5 | 4 | 4 | 6 | 0 | 11 | 15 | 1 | 14 | 4 | 3 | 5 | 1 | 9 | 2 | 6 | 2 | 5 | 3 |
Philippines(n = 104) | 22 | 25 | 17 | 18 | 20 | 2 | 30 | 71 | 3 | 46 | 18 | 7 | 28 | 5 | 19 | 20 | 23 | 27 | 11 | 4 |
Singapore (n = 38) | 12 | 3 | 5 | 7 | 10 | 1 | 10 | 28 | 0 | 14 | 9 | 6 | 8 | 1 | 1 | 5 | 9 | 12 | 11 | 0 |
Thailand (n = 22) | 4 | 10 | 8 | 0 | 0 | 0 | 9 | 12 | 1 | 8 | 11 | 1 | 2 | 0 | 4 | 3 | 2 | 6 | 5 | 2 |
Vietnam (n = 95) | 28 | 17 | 19 | 12 | 15 | 4 | 44 | 48 | 3 | 38 | 18 | 11 | 26 | 2 | 32 | 3 | 16 | 10 | 11 | 23 |
Other (small cells combined) (n = 3) | 1 | 2 | 0 | 0 | 0 | 0 | 2 | 1 | 0 | 0 | 1 | 2 | 0 | 0 | 1 | 0 | 0 | 0 | 2 | 0 |
NEA (n = 437) | ||||||||||||||||||||
Mainland China (n = 179) | 73 | 51 | 29 | 16 | 8 | 2 | 74 | 104 | 1 | 123 | 33 | 11 | 6 | 6 | 9 | 35 | 55 | 42 | 22 | 16 |
Hong Kong / Macau (n = 14) | 4 | 6 | 1 | 2 | 1 | 0 | 3 | 10 | 1 | 9 | 5 | 0 | 0 | 0 | 0 | 0 | 5 | 4 | 4 | 1 |
Taiwan (n = 41) | 5 | 20 | 8 | 2 | 6 | 0 | 11 | 30 | 0 | 21 | 9 | 3 | 6 | 2 | 3 | 5 | 14 | 12 | 3 | 4 |
Japan (n = 23) | 4 | 5 | 13 | 1 | 0 | 0 | 3 | 20 | 0 | 8 | 13 | 1 | 0 | 1 | 3 | 3 | 5 | 5 | 5 | 2 |
Korean peninsula (n = 180) | 35 | 80 | 55 | 7 | 3 | 0 | 33 | 147 | 0 | 78 | 80 | 19 | 2 | 1 | 11 | 17 | 37 | 54 | 55 | 6 |
Unknown (n = 142) | 21 | 32 | 11 | 19 | 5 | 54 | 37 | 44 | 61 | 23 | 39 | 2 | 9 | 69 | 16 | 9 | 17 | 10 | 7 | 82 |
TOTAL (n = 1489) | 396 | 429 | 313 | 167 | 116 | 68 | 524 | 880 | 85 | 619 | 516 | 104 | 134 | 116 | 219 | 179 | 329 | 295 | 220 | 247 |
Participant ID 1 | Place of Birth | State of Residence | Gender | Length of Time in Australia (Years) |
---|---|---|---|---|
Participant 1 1 | SSA | Western Australia | Woman | 11 |
Participant 2 1 | SSA | Western Australia | Woman | 16 |
Participant 3 1 | SSA | Western Australia | Woman | 18 |
Participant 4 1 | SSA | Western Australia | Woman | Not stated |
Participant 5 1 | SSA | Western Australia | Man | Not stated |
Participant 6 | SEA | Western Australia | Woman | 7 |
Participant 7 | SEA | Western Australia | Woman | 3 |
Participant 8 | NEA | Western Australia | Woman | 11 |
Participant 9 | SSA | Western Australia | Woman | 5 |
Participant 10 | SSA | Western Australia | Man | 17 |
Participant 11 | SEA | Western Australia | Man | 16 |
Participant 12 | SEA | Queensland | Man | 6 |
Participant 13 | NEA | Queensland | Woman | 14 |
Participant 14 | NEA | Queensland | Man | 18 |
Participant 15 | NEA | Queensland | Man | 25 |
Participant 16 | SEA | Queensland | Woman | 10 |
Participant 17 | SEA | Queensland | Man | 22 |
Participant 18 | NEA | Queensland | Man | 4 |
Participant 19 | SSA | Queensland | Man | 8 |
Participant 20 | SEA | Queensland | Man | 10 |
Participant 21 | NEA | Queensland | Man | 20 |
Participant 22 | NEA | Queensland | Man | 3 |
Participant 23 | NEA | Queensland | Man | 4 |
Responses, n(%) | |||
---|---|---|---|
Demographic Variables | Yes (Correct) | No/I Don’t Know | p-Value |
MSM (n = 46) | 32 (69.57) | 14 (30.43) | <0.001 |
Non-MSM men (n = 418) | 58 (13.88) | 360 (86.12) | |
Men (n = 478) | 95 (19.87) | 383 (80.13) | 0.001 |
Women (n = 817) | 106 (12.97) | 711 (87.03) | |
NEA (n = 411) | 46 (11.19) | 365 (88.81) | <0.001 |
SEA (n = 503) | 72 (14.31) | 431 (85.69) | |
SSA (n = 331) | 73 (22.05) | 258 (77.95) | |
18–29 year olds (n = 368) | 67 (18.21) | 301 (81.79) | <0.001 |
30–39 year olds (n = 402) | 84 (20.90) | 318 (79.10) | |
40–49 year olds (n = 291) | 38 (13.06) | 253 (86.94) | |
50–59 year olds (n = 152) | 11 (7.24) | 141 (92.76) | |
60+ year olds (n = 99) | 6 (6.06) | 93 (93.94) |
Responses, n(%) | |||
---|---|---|---|
Sexual Practice | Yes | No/Can’t Recall | p-Value |
Most recently had sex with committed partner (n = 704) | 222 (31.53) | 482 (68.47) | <0.001 |
Most recently had sex with a non-committed partner (n = 83) | 47 (56.63) | 36 (43.37) | |
Only one sex partner in past 12 months (n = 644) | 192 (29.81) | 452 (70.19) | <0.001 |
Multiple sex partners in past 12 months (n = 139) 1 | 72 (51.80) | 67 (48.20) | |
NEA (n = 296) | 131 (44.26) | 165 (55.74) | <0.001 |
SEA (n = 272) | 88 (32.35) | 184 (67.65) | |
SSA (n = 180) | 40 (22.22) | 140 (77.78) | |
MSM (n = 38) | 19 (50.00) | 19 (50.00) | 0.049 |
Non-MSM men (n = 166) | 84 (33.60) | 166 (66.40) |
Respondents n (% of Sub-Group) | |||
---|---|---|---|
Reasons 1 | One Partner in Past 12 Months (Committed) (n = 424) | Multiple Partners 2 in Past 12 Months or in Non-Committed Relationship with Most Recent Partner (n = 82) | p-Value |
My partner and/or I did not have one | 25 (5.90) | 10 (12.20) | 0.040 |
My partner and/or I could not afford one | 3 (0.71) | 2 (2.44) | 0.147 |
My partner did not want to use one | 62 (14.62) | 13 (15.85) | 0.774 |
I did not want to use one | 62 (14.62) | 24 (29.27) | 0.001 |
My partner and/or I did not know where to get one | 1 (0.24) | 2 (2.44) | 0.017 |
My partner doesn’t like the way they feel | 47 (11.08) | 14 (17.07) | 0.127 |
I don’t like the way they feel | 46 (10.85) | 17 (20.73) | 0.013 |
My partner or I was trying to get pregnant | 56 (13.21) | 7 (8.54) | 0.241 |
It is against my or my partner’s culture or religion | 10 (2.36) | 2 (2.44) | 0.965 |
My partner and I don’t have any illnesses that can be passed on through sex | 161 (37.67) | 23 (28.05) | 0.087 |
My partner and I trust each other | 206 (48.58) | 24 (29.27) | 0.001 |
Another reason | 37 (8.73) | 9 (10.98) | 0.517 |
Category | Reasons 2 | Survey Respondents n(%) 1 |
---|---|---|
Risk assessment | I did not do anything to put me at risk | 496 (64.00) |
Symptoms | I did not have any symptoms | 236 (30.45) |
Priorities | I did not think it was important | 70 (9.03) |
I did not have the time to get tested | 38 (4.90) | |
Service access barriers | I didn’t know where to get one | 50 (6.45) |
I could not afford extra tests | 22 (2.48) | |
I don’t like needles/blood tests | 22 (2.48) | |
I could not get to a service/clinic | 11 (1.42) | |
Psychological | I was too embarrassed | 13 (1.68) |
I was scared about the result | 12 (1.55) | |
Other | Another reason | 64 (8.26) |
Variable | Tested for HIV in Last Two Years | ||
---|---|---|---|
n(%) | p-Value | ||
Region of Birth (n = 1125) | |||
NEA | 54 (13.88) | <0.001 | |
SEA | 53 (11.65) | ||
SSA | 71 (25.27) | ||
Gender (n = 1163) | |||
Man | 79 (18.37) | 0.050 | |
Woman | 103 (14.05) | ||
Age in years (n = 1176) | |||
18–29 | 51 (15.69) | <0.001 | |
30–39 | 91 (24.66) | ||
40–49 | 37 (13.55) | ||
50–59 | 4 (3.33) | ||
60+ | 1 (13.90) | ||
Years in Australia (n = 1141) | |||
0–9 | 94 (17.94) | 0.054 | |
10–19 | 64 (15.02) | ||
20–29 | 14 (16.67) | ||
30+ | 8 (7.48) | ||
Visa status (n = 1155) | |||
Permanent resident/citizen | 129 (15.83) | 0.919 | |
Other visa | 53 (15.59) | ||
SEIFA decile (n = 1041) | |||
1 | 21 (21.21) | 0.049 | |
2 | 10 (14.49) | ||
3 | 6 (26.09) | ||
4 | 10 (8.00) | ||
5 | 24 (13.41) | ||
6 | 24 (25.53) | ||
7 | 16 (16.49) | ||
8 | 26 (15.85) | ||
9 | 21 (17.07) | ||
10 | 12 (17.65) | ||
Languages spoken at home (n = 400) | |||
Language(s) other than English only | 42 (21.43) | 0.265 | |
Only English | 24 (28.57) | ||
English and at least one other language | 16 (18.60) | ||
MSM status (n = 1151) | |||
MSM | 25 (58.14) | <0.001 | |
Not MSM | 155 (13.99) | ||
Aware of PrEP (n = 1122) | |||
Yes | 60 (33.15) | <0.001 | |
No | 119 (12.65) | ||
Aware STIs can be asymptomatic (n = 1063) | |||
Yes | 155 (23.07) | <0.001 | |
No | 26 (6.65) | ||
Aware HIV test not part of all blood tests (n = 1123) | |||
Yes | 86 (18.07) | 0.110 | |
No | 94 (14.53) | ||
Number of sexual partners in last year (n = 978) | |||
0 | 30 (9.68) | <0.001 | |
1 | 85 (15.21) | ||
≥2 | 46 (42.20) | ||
Identity of last sexual partner (n = 758) | |||
Committed partner | 109 (16.01) | <0.001 | |
Non-committed partner | 33 (42.86) | ||
Condom used at last sexual encounter (n = 686) | |||
Yes | 54 (22.98) | 0.117 | |
No/can’t recall | 81 (17.96) | ||
Travelled overseas since January 2018 (n = 1183) | |||
Yes | 129 (16.88) | 0.138 | |
No | 57 (13.60) |
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Vujcich, D.; Reid, A.; Brown, G.; Durham, J.; Guy, R.; Hartley, L.; Mao, L.; Mullens, A.B.; Roberts, M.; Lobo, R. HIV-Related Knowledge and Practices among Asian and African Migrants Living in Australia: Results from a Cross-Sectional Survey and Qualitative Study. Int. J. Environ. Res. Public Health 2023, 20, 4347. https://doi.org/10.3390/ijerph20054347
Vujcich D, Reid A, Brown G, Durham J, Guy R, Hartley L, Mao L, Mullens AB, Roberts M, Lobo R. HIV-Related Knowledge and Practices among Asian and African Migrants Living in Australia: Results from a Cross-Sectional Survey and Qualitative Study. International Journal of Environmental Research and Public Health. 2023; 20(5):4347. https://doi.org/10.3390/ijerph20054347
Chicago/Turabian StyleVujcich, Daniel, Alison Reid, Graham Brown, Jo Durham, Rebecca Guy, Lisa Hartley, Limin Mao, Amy B. Mullens, Meagan Roberts, and Roanna Lobo. 2023. "HIV-Related Knowledge and Practices among Asian and African Migrants Living in Australia: Results from a Cross-Sectional Survey and Qualitative Study" International Journal of Environmental Research and Public Health 20, no. 5: 4347. https://doi.org/10.3390/ijerph20054347