P23. Assessing HIV related knowledge in an immigrant population-based survey

Paula J Tiittala¹ ², Pia S Kivelä¹, Matti A Ristola¹, Kirsi Liitsola²
Affiliates: Helsinki University Hospital¹ National Institute for Health and Welfare²

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Background
During recently, Europe has experienced an increased pressure of migration due to global political, environmental and economic crisis. Migrants are overrepresented among the newly diagnosed HIV cases in many European countries, including Finland. Migrants’ increased susceptibility to HIV is influenced by the epidemiological situation and mal-functioning health care systems in the countries of origin, the conditions during transit and post-migration and possible risk behavior. Existing barriers to health care also in host countries result to migrants having a higher risk for late diagnosis of HIV. Good knowledge on HIV has been associated with tolerant attitudes towards the HIV infected and risk diminishing practices such as HIV testing, needle exchange and safe sex practices. Understanding the HIV related knowledge, attitudes and practices of migrants will enable to better design preventive measures and strategies for early diagnosis.

Methods
HIV knowledge was assessed using five validated UNGASS core indicator questions. An additional question on the treatment possibility of HIV was added (UNGASS+1). Good knowledge on HIV was determined by answering correct to all of the UNGASS+1 questions. Altogether 1366 immigrants of Russian, Somali and Kurdish background participated in the Finnish Migrant Health and Wellbeing Study (“Maamu”) health examination in 2011-2012. During the health examination the participants were posed the UNGASS+1 questions. After the survey, the false answers were corrected and all the participants were offered an HIV test. The factors influencing good HIV knowledge were analyzed using logistic regression.

Results
1354 (99 %) participants to the Maamu health examination responded to the UNGASS+1 questions partly or completely. 262 (19 %) participants answered correct to all of the UNGASS+1 indicator questions. Belonging to Russian language group (AOR 2,645, 95 % CI 1,782-3,924), having secondary education (AOR 1,764, 95 % CI 1,230-2,530), being employed (AOR 1,539, 95 % CI 1,132-2,092), using the Internet daily (AOR 4,229, 95 % CI 1,483-12,062) and having participated in previous HIV testing (AOR 1,683, 95 % CI 1,218-2,326) were associated with significantly higher HIV knowledge. 1290 (95 %) participants accepted the HIV test offered after the knowledge assessment.

Conclusions
In this study, HIV knowledge of immigrants was successfully assessed with the UNGASS+1 indicator questions. The response rate to the questions was high. The study participants had important shortages in HIV knowledge. Therefore, especially the “marginalized among the marginalized” should be considered when planning preventive and educational campaigns on HIV. Those who had been previously tested for HIV had better knowledge on how to prevent and treat HIV. The result suggests that HIV testing including pre-test counseling might be an efficient strategy for prevention among risk populations. Moreover, a population survey on HIV knowledge can be considered as an educational intervention when knowledge assessment is followed by correction of the false answers. Acknowledging the good treatment possibilities of HIV might encourage participants to accept the HIV test.