Assessing the HIV/AIDS health services needs of African immigrants to Houston

This study investigated HIV/AIDS knowledge, risk behaviors and perceptions, and access to services among Black immigrants from more than 20 African nations to Houston, Texas, United States. Three hundred nine respondents completed a 98-item self-administered questionnaire on HIV/AIDS knowledge, risk behaviors, access to services, and stigma. Data analysis revealed this population to be highly educated (70.9% had educational attainment levels beyond high school), with a plurality motivated to immigrate to the United States for academic reasons (45.0%). As a group they displayed a high level of knowledge about modes of HIV transmission. Generally, Christian background respondents had higher knowledge than those of Muslim background. Nevertheless, 36.3% reported that they had never used a condom, with the overwhelming majority of respondents reporting low self-perceived risk for contracting HIV (79.5%). These findings, together with the persistent practice of traditional rituals such as body scarring/tattooing by a significant minority (20.1%), a lack of awareness about vertical transmission (16.3% of women; 29.9% of men), and discouraging scores on an HIV stigma perception scale, suggest that a targeted campaign to raise awareness in this population is warranted.