Amsterdam 2015
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| Abstract #2288 - Community engagement | ||||
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Session: 49.2: Community engagement (Parallel) on Friday @ 09.00-10.30 in 202 Chaired by Javier Toledo, Avrom Sherr Authors: Presenting Author: Prof. Sónia Dias - Instituto de Higiene e Medicina Tropical, Portugal |
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| Additional Authors: | ||||
| Aim: This paper presents a HIV research project conducted with migrants in Portugal and discusses the advantages and challenges of adopting a participatory approach. | ||||
| Method / Issue: HIV infection continues to be a concern in global public health. In low-level and concentrated epidemics, sub-populations considered most-at-risk for HIV infection and transmission include migrants, particularly from generalized epidemic regions as Sub-Saharan Africa. HIV epidemiological research is crucial to understand the burden and determinants of HIV. However, one main difficulty in conducting HIV research in such vulnerable populations is to define and reach migrant subgroups. Frequently they are unwilling to participate in research due to mistrust/disinterest or reluctance in jeopardizing to reveal their migration status, risk behaviours and HIV-status. These circumstances render these subgroups understudied and underserved. Participatory research has been recognized as extremely useful in collaboratively identifying key-health problems and translating research results into actions that improve communities’ health. | ||||
| Results / Comments: A cross-sectional survey with African immigrants was developed using a participatory approach. All stakeholders – representatives from policy-making, health services, academia, NGOs, immigrant associations and community - participated actively in designing the project, implementing the fieldwork and interpreting the results. Initially, a geographic/network mapping was conducted based on a formative research with community partners to identify data collection sites. Data were collected on those sites using an anonymous structured questionnaire applied by immigrant trained interviewers, recruited and ed in collaboration with community partners. After completing the questionnaire, all respondents were offered an HIV rapid test. Firstly, deep discussion within partnership and meaningful consensus of the project’s focus and boundaries was required. It implied negotiation between academics with their focus on scientific rigor and civil society with their commitment with advocacy for migrant rights, which was possible through the liaison with migrant associations that have outreach-work experience on HIV prevention with migrants. This was crucial for community partners to acknowledge the project as a priority, thus publicize it to their social networks and immigrant community. Questions emerged about which best methodological options to adopt, what information to collect, the pros/cons of using interviewer-applied/self-administered questionnaire, and ethical issues related to community’s protection. The HIV rapid test offered raised ethical questions on confidentiality and guarantee of a referral system to appropriate healthcare. The participatory approach enhanced study compliance the survey comprised a large sample of migrants (n=784) and gathered a great amount of data on HIV prevalence and its sociodemographic, behavioural and structural determinants. | ||||
| Discussion: Clear advantages of using participatory approach were the enhancement of research relevance to the community, study design appropriateness to migrant population and enriched interpretation of results. Specific challenges encountered provided an important ground for reflection about this approach. Despite being a complex, challenging and lengthy process, adopting a participatory approach is an effective way to obtain evidence on specific needs of migrants and identify intervention priorities. Also, involving community partners throughout the project contributed to enhance their capacity building for HIV prevention. | ||||
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